摘要
目的探讨血清胱抑素C(CysC)水平与新发前循环缺血性卒中患者严重程度及临床预后之间相关性。方法前瞻性收集2018年12月至2019年2月作者医院就诊的急性前循环缺血性卒中患者235例(卒中组)和同期就诊的疑似睡眠呼吸暂停低通气综合征受试者72例作为对照组。收集受试者基线一般人口学信息、血清CysC水平及血管病相关危险因素,并随访3个月。卒中严重程度应用美国国立卫生研究院卒中量表(NIHSS)评分进行评价,预后评价应用改良Rankin量表(mRS)评分。使用二元Logistic回归分析缺血性卒中发病的影响因素,采用t检验比较不同严重程度及预后患者间血清CysC水平差异。结果与对照组相比,卒中组血清CysC水平升高[(1.24±0.42)mg/L比(0.77±0.27)mg/L,P< 0.01]。年龄、吸烟、高血压、糖尿病、高胆固醇血症和血清CysC水平升高是急性前循环缺血性卒中的独立危险因素(P< 0.05);轻型卒中组(NIHSS≤3分)与非轻型卒中组间CysC水平无统计学差异[(1.23±0.34)mg/L比(1.26±0.37)mg/L,P>0.05];预后良好组(mRS<2)与预后不良组间CysC水平无统计学差异[(1.22±0.32)mg/L比(1.28±0.44)mg/L,P> 0.05]。结论血清CysC水平升高可能是新发前循环缺血性卒中的独立危险因素,但其与卒中严重程度或长期预后无相关性。
Objective To investigate whether there is a correlation between baseline serum cystatin C(Cys C) level and the severity or clinical outcome of patients with acute ischemic stroke in anterior circulation. Methods This prospective case control study enrolled 235 patients with newly onset ischemic stroke in anterior circulation in Department of Neurology and 72 participants with possible obstructive sleep apnea syndrome as control subjects from Department of Respiratory,consecutively,from December 2018 to February 2019. Baseline characteristics,including demographic information,serum Cys C levels,and classic vascular risk factors,as well as the clinical outcome indexes followed for 3 months,were assessed and collected. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) score,and prognostic evaluation using the modified Rankin Scale (mRS) score. Association between risk factors and incident stroke were analyzed by Logistic regression,and adjusted for age,gender and relevant confounders;the difference of the level of Cys C between subjects with different severity and prognosis were analyzed with t test. Results Compared with the non-stroke control group,serum Cys C levels were significantly higher in patients with acute stroke (1.24±0.42 mg/L vs . 0.77±0.27 mg/L, P <0.01). Age,smoking,hypertension,diabetes,hypercholesterolemia,and elevated serum Cys C were independent risk factors of acute ischemic stroke in anterior circulation ( P <0.05). The difference of serum Cys C levels between minor stroke group (NIHSS≤3) and non-minor group (1.23±0.34 mg/L vs . 1.26±0.37 mg/L, P >0.05) was not significant. The serum Cys C levels in good prognosis group (mRS<2) was similar to the poor prognosis group(1.22±0.32 mg/L vs . 1.28± 0.44 mg/L, P >0.05). Conclusions Elevated serum Cys C level is an independent risk factor for acute ischemic stroke in anterior circulation. However,there is no association between serum Cys C levels and the severity or the long-term prognosis.
作者
李路娟
孙磊磊
杨宇
张然
马翠红
李勇
侯书敏
杜海松
张江涛
LI Lujuan;SUN Leilei;YANG Yu;ZHANG Ran;MA Cuihong;LI Yong;HOU Shumin;DU Haisong;ZHANG Jiangtao(Department of Neurology,Chengde Central Hospital,Chengde 067000,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2019年第5期331-333,338,共4页
Chinese Journal of Neuroimmunology and Neurology
基金
承德市科学技术研究与发展计划项目(201804A011)
