血清胱抑素C水平与脑小血管病关系的研究  

Study on the relationship between serum cystatin C level and cerebral small vessel disease

作　　者：张新奇 张杰文 黄月 ZHANG Xinqi;ZHANG Jiewen;HUANG Yue(Department of Neurology,People's Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院神经内科,河南郑州450003

出　　处：《中国实用神经疾病杂志》2018年第21期2356-2360,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技厅科技攻关项目(编号:172102310017)

摘　　要：目的肾功能不全与脑小血管病(CSVD)有关。半胱氨酸蛋白酶抑制剂(Cysc)是一种相比基于肌酐的估计方程式更有效的评估肾功能方法,然而半胱氨酸蛋白酶抑制剂(Cysc)血浆水平和CSVD之间的关系尚未得到充分研究,本文调查研究两者之间的关联。方法收集患者临床资料,包括血浆(Cysc)水平和MRI影像,进行了评估。使用Fazekas量表评估WMH。通过使用多变量逻辑回归分析来调查Cysc和CVSD之间的关系。结果本研究显示Cysc升高为导致cSVD的危险因素。在多因素调整Logistic分析中,CysC水平升高与WMH严重程度显著相关,优势比(OR)(95%置信区间:CI)1.081(1.041～1.122)。有序多分类Logistic回归分析显示患者的CysC水平与未经调整的WMH严重程度显著相关。Cyscs水平每增长1mg,WMH严重程度分级增高一个等级的优势比为(1.064),95%置信区间为(1.033;1.095)。结论在CSVD患者中,Cysc升高为导致cSVD的危险因素,血清CysC水平与WMH严重程度相关。Objective Renal insufficiency is associated with cerebral small vessel disease(CSVD).Cystatin inhibitor(Cysc)is a more effective method for assessing renal function than the creatinine based estimation equation.However,the relationship between cysteine protease inhibitor(Cysc)plasma levels and CSBD has not been fully established.Research,we investigated the relationship between the two.Methods Patient clinical data,including plasma(Cysc)levels and MRI images,were collected and evaluated.We used logistic regression to evaluate the associations of CysC level with white matter hyperintensities(WMH).The relationship between Cysc and CVSD was investigated by using multivariate logistic regression analysis.Results This study shows that Cysc is elevated as a risk factor for cSVD.In multivariate adjusted logistic analysis,elevated CysC levels were significantly associated with WMH severity,odds ratio(OR)(95% confidence interval:CI)1.081(1.041 to 1.122).Ordered multi class logistic regression analysis showed that patients'CysC levels were significantly associated with unadjusted WMH severity.For every 1 mg increase in Cyscs levels,the odds ratio for a grade of WMH severity is increased by one level(1.064),and the 95% confidence interval is(1.033;1.095).

关 键 词：脑小血管病 慢性肾病 胱抑素C 核磁共振 脑白质病变 白质高信号 Fazekas评分 

分 类 号：R743[医药卫生—神经病学与精神病学]