动态监测不同亚型急性脑梗死血清胱抑素C的临床意义  

Clinical Significance of Dynamic Monitoring of Serum Cystatin - C in Different Subtypes of Acute Cerebral Infarction

作　　者：肖雅娟[1] 冯利东 吴跃华[1] 

机构地区：[1]内蒙古自治区包头市第四医院神经内科,中国包头014030 [2]内蒙古自治区包头市包钢三医院神经内科,中国包头014030

出　　处：《国际老年医学杂志》2017年第1期1-4,共4页International Journal of Geriatrics

基　　金：内蒙古包头市科技局基金（wsjj2014039）

摘　　要：目的：探讨不同亚型急性脑梗死患者血清胱抑素C（Cys-C）在不同时间点的变化趋势及临床意义。方法：选择我院收治的神经内科发病48h以内的急性脑梗死病人100例为脑梗死组，按TOAST病因分型分为不同的亚型，所有脑梗死组患者入院后采用美国国立卫生研究院卒中量表（The National Institutes of Health Stroke Scale NIHSS）评分进行分组，同时选取年龄、性别、居住地与各组相匹配的门诊健康体检者60例为对照组，各组间一般资料比较无统计学意义（P〉0．05），具有可比性。所有入选病例入院后24h化验血清Cys-C、血糖、血脂、血浆纤维蛋白原（FIB），治疗后第7、14d再次化验血清Cys-C水平，进行比较分析。结果：急性脑梗死组不同时间点血清Cys-C水平均较健康对照组升高（P〈0．01），各亚型中大动脉粥样硬化型（LAA）、小动脉闭塞型（SAO）组血清Cys-C水平不同时间点均高于对照组（P〈0．01），其中LAA组增高显著。相关性分析显示急性脑梗死组血清Cys-C水平与年龄及入院时NIHSS评分呈正相关（r=0．412，0．38；P均〈0．01），与性别、FIB、血糖、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白无关。结论：血清Cys-C与不同亚型急性脑梗死关系密切，动态监测并及时干预有利于急性脑梗死的早期诊断、梗死程度及预后的评估，降低发病率。OBJECTIVE ： To explore the clinical significance of the serum cystatin - C in different subtypes of acute cerebral in- farction （ACI）. METHODS： I00 patients with ischemie stroke within 48h in our department of Neurology were collected. According to the etiology TOAST classification, all the patients were divided into different subtypes. And all hospitalized patients in the cerebral infarction group were divided into groups by the National Institutes of Health Stroke Scale NIHSS. At the same time, 60 health outpa- tients in age, sex residence and ethnic groups matched were selected as the control group. There was no statistical significance in each group （ P 〉 0.05 ）. Serum Cys - C, blood sugar, blood fat and fibrinogen at 24 hours after admission were tested. Serum Cys - C level was tested again on the 7th andl4th day after treatment and was analyzd. RESULTS： The levels of serum Cys - C in acute cere- bral infarction group at different time points were higher than those in healthy controls （P 〈 0. 01 ）. In each subtype of group LAA、SAO and the levels of serum Cys - C in different time points were higher than those in the control group （P 〈0. 01 ）. The LAA group increased significantly. Correlation analysis showed that the level of serum Cys - C in ACI group was positively associated with age and NIHSS scores on admission （ r = 0. 412,0.38 ;P 〈0. 01, 0. 01 ） and was not related to the sex, FIB, blood sugar, triglyceride, total cholesterol, high - density lipoprotein cholesterol （HDL） and low density lipoprotein cholesterol （LDL）. CONCLUSIONS ： The level of serum Cys - C is closely associated with different subtypes of ACI. Dynamic monitoring of serum Cys - C and timely interven- tion is good for the early diagnosis and prognosis evaluation of acute cerebral infarction. It can effectively reduce the incidence of ACI.

关 键 词：急性脑梗死 TOSAT 胱抑素C 动态 临床意义 

分 类 号：R743.33[医药卫生—神经病学与精神病学]