急性脑梗死患者血浆胱抑素 C、同型半胱氨酸水平与颈动脉粥样硬化的相关性分析

摘要

目的：探讨急性脑梗死患者血清胱抑素 C、同型半胱氨酸水平与颈动脉粥样硬化的相关性。方法选择2011年3-8月在天津市武清区人民医院神经内科住院的急性脑梗死患者346例，根据颈动脉超声检查结果分为无斑块组135例和斑块组211例。记录两组患者一般资料，检测其空腹血糖、血脂、超敏 C 反应蛋白、胱抑素 C、同型半胱氨酸。结果单因素分析结果显示，两组患者性别，吸烟史、饮酒史、糖尿病病史、高血压病史阳性率，空腹血糖，血清总胆固醇、高密度脂蛋白胆固醇水平比较，差异均无统计学意义（ P >0.05）；斑块组患者年龄大于无斑块组，血清三酰甘油水平低于无斑块组，低密度脂蛋白胆固醇、超敏 C 反应蛋白、胱抑素 C、同型半胱氨酸水平高于无斑块组（P <0.05）。Pearson 相关分析结果显示，斑块组患者血清胱抑素 C、同型半胱氨酸水平均与 Crouse 积分呈正相关（r =0.141，P =0.01；r =0.142，P =0.01）。多元 Logistic 回归分析结果显示，年龄、超敏 C 反应蛋白、胱抑素 C、同型半胱氨酸为颈动脉粥样硬化斑块形成的危险因素。结论胱抑素 C、同型半胱氨酸是急性脑梗死患者颈动脉粥样硬化斑块形成的危险因素，二者共同参与了急性脑梗死患者颈动脉粥样硬化的发生和发展过程。%Objective To analysis the correlation between serum levels of cystatin C,homocysteine and carotid artery atherosclerosis in patients with acute cerebral infarction. Methods From March to August in 2011,346 patients with acute cer-ebral infarction in Department of Neurology,People's Hospital of Wuqing District were selected,and then they were divided into groups A(without plaques,n = 135) and B( with plaques,n = 211) according to carotid ultrasound examination results. General data of the two groups were recorded,and fasting plasma glucose(FPG),blood lipid,high - sensitivity C - reactive protein(hs - CRP),cystatin C,homocysteine were detected. Results Univariate analysis showed that,there was no signifi-cant differences of gender,smoking history,drinking history,diabetes history,hypertension history,FPG,total cholesterol (TC),high density lipoprotein cholesterol(HDL - C)between the two groups(P > 0. 05);while triglyceride(TG)was low-er than that of A group age,low density lipoprotein cholesterin(LDL - C),hs - CRP,cystatin C,homocysteine of B group were higher than those of A group(P < 0. 05). Pearson correlation analysis showed that,serum levels of cystatin C,homocys-teine were positively correlated with Crouse score(r = 0. 141,P = 0. 01;r = 0. 142,P = 0. 01)in B group. Multivariate Lo-gistic analysis showed that,age,hs - CRP,cystatin C,homocysteine were risk factors of carotid artery atherosclerotic plaque formation. Conclusion Cystatin C,homocysteine are risk factors of carotid artery atherosclerotic plaque formation in patients with acute cerebral infarction,they both take participate in the onset and development of carotid artery atherosclerosis.