急性脑梗死患者血清CysC hs-CRP水平与机体易感性的关系分析

Analysis of the relationship between serum CysC,hs-CRP levels and body susceptibility in patients with acute cerebral infarction

目的探讨血清胱抑素(CysC)、超敏C反应蛋白(hs-CRP)与急性脑梗死患者TOAST亚型及机体易感性的关系。方法回顾性选取辽宁省金秋医院2020-08—2022-09入院时未发生感染的急性脑梗死患者90例为观察组,按TOAST标准分型分为大动脉粥样硬化型组(LAA组)42例,心源性栓塞型组(CE组)21例,小动脉闭塞型组(SAO组)27例,同时选取同期进行体检的60例健康者为对照组。应用Spearman相关性分析血清CysC、hs-CRP水平与急性脑梗死TOAST亚型和机体易感性的关系,利用ROC曲线分析血清CysC、hs-CRP对机体易感性的预测价值,并采用Logistic回归模型对机体易感性的影响因素进行分析。结果LAA组、CE组血清CysC、hs-CRP水平均高于对照组,SAO组血清CysC、hs-CRP水平明显低于CE组(P<0.05);Spearman相关性分析表明CysC和hs-CRP与CE组有显著正相关性(r_(s)=0.310,P=0.008;r_(s)=0.302,P=0.010),与SAO组呈负相关关系(r_(s)=—0.320,P=0.005;r_(s)=—0.305,P=0.011)。观察组中21例患者发生感染,CysC、hs-CRP水平明显高于未感染者(P<0.05);Spearman相关性分析表明CysC、hs-CRP水平与机体易感性有显著正相关性(r_(s)=0.509,P=0.006;r_(s)=0.648,P<0.001)。ROC曲线发现hs-CRP预测机体易感性的曲线下面积为0.912(95%CI:0.894~0.993,P<0.001);CysC预测机体易感性的曲线下面积为0.893(95%CI:0.840~0.903,P=0.004);多因素Logistic回归分析表明,CysC、hs-CRP是机体易感性的独立影响因素(P<0.05)。结论不同TOAST亚型急性脑梗死患者血清CysC、hs-CRP水平有一定差别,其可作为脑梗死急性期的血清标志物之一,且与患者机体易感性呈正相关,对临床治疗急性脑梗死具有一定的参考价值。

Objective To investigate the relationship between serum cystatin(CysC),hypersensitive C-re⁃active protein(hs-CRP)and TOAST subtype and susceptibility in patients with acute cerebral infarction.Methods Ninety patients with acute cerebral infarction who were admitted to Jinqiu Hospital of Liaoning Province from August 2020 to September 2022 were retrospectively selected as the observation group.According to the TOAST standard,they were divided into large atherosclerosis group(42 cases),cardiac embolization group(21 cases)and small artery occlusion group(27 cases).Meanwhile,60 healthy subjects who underwent physical examination during the same period were selected as the control group.Spearman correlation analysis was used to ana⁃lyze the relationship between serum CysC and hs-CRP levels and the TOAST subtype of acute cerebral infarction and the body susceptibility,ROC curve was used to analyze the predictive value of serum CysC and hs-CRP on the body susceptibility,and Logistic regression model was used to analyze the influencing factors for the body sus⁃ceptibility.Results The levels of CysC and hs-CRP in the LAA and CE groups were higher than those in the control group,while the levels of CysC and hs-CRP in the SAO group were significantly lower than those in the CE group(P<0.05).Spearman correlation analysis showed that CysC and hs-CRP were significantly positively cor⁃related with the CE group(r_(s)=0.310,P=0.008;r_(s)=0.302,P=0.010),while negatively correlated with the SAO group(r_(s)=-0.320,P=0.005;r_(s)=-0.305,P=0.011).In the observation group,21 patients developed organic infections,and the levels of CysC and hs-CRP were significantly higher than those in the non-infected patients(P<0.05).Spearman correlation analysis showed a significant positive correlation between CysC,hs-CRP levels and body sus⁃ceptibility(r_(s)=0.509,P=0.006;r_(s)=0.648,P<0.001).The ROC curve found that the area under the curve predicted by hs-CRP for body susceptibility was 0.912(95%CI:0.894-0.993,P<0.001).The area under the curve predicted by CysC for body susceptibility was 0.893(95%CI:0.840-0.903,P=0.004).Multivariate Logistic regression analysis showed that CysC and hs-CRP were independent influencing factors for body susceptibility(P<0.05).Conclusion There are certain differences in the levels of serum CysC and hs-CRP among patients with acute cerebral infarction of different TOAST subtypes,which can be used as one of the serum biomarkers for the acute phase of cerebral infarction and is positively correlated with the susceptibility of the patient’s body.It has certain reference value for clinical treatment of acute cerebral infarction.