老老年缺血性脑白质病变患者严重程度与血清胱抑素C的关系

摘要

目的 探讨老老年(＞85岁)缺血性脑白质病变患者严重程度与血清胱抑素C的相关性.方法 选择行头颅MRI检查的缺血性脑白质病变患者115例,根据年龄相关的白质改变量表进行分组,轻度组(1～4分)42例,中度纽(5～8分)42例,重度组(≥9分)31例.收集各组患者年龄、高血压、糖尿病、肾脏疾病、冠心病、慢性支气管炎、高脂血症、腔隙性脑梗死等病史,血清胱抑素C、肌酐、尿素等指标并进行比较,采用有序多分类logistic回归分析血清胱抑素C与缺血性脑白质病变的相关性.结果 与轻度组比较,中度组和重度组糖尿病比例明显升高(P＜0.05,P＜0.01).重度组血清胱抑素C水平明显高于轻度组和中度组[(1.7±1.8)mg/L vs (0.7±0.6) mg/L、(0.9±0.6)mg/L,P＜0.05].校正年龄、高血压、糖尿病等因素后,多因素logistic回归分析显示,血清胱抑素C水平是缺血牲脑白质病变严重程度增加的独立危险因素(OR=2.743,95％CI:0.497～1.527,P=0.000).Spearman等级相关分析显示,血清胱抑素C水平升高与缺血性脑白质病变严重程度呈正相关(r=0.344,P=0.000).结论 血清胱抑素C水平升高可能与老老年患者缺血性脑白质病变的严重程度相关.%Objective To study the relationship between white matter ischemic lesion (WMIL) severity and serum cystatin C (Cys-C) level in ＞85 years old patients.Methods One hundred and fifteen WMIL patients were divided into mild WMIL group (n=42),moderate WMIL group (n=42) and severe WMIL group (n =31).Their age,history of hypertension,DM,nephrosis,CHD,cronic bronchitis,hyperlipidaemia,lacuna stroke and serum levels of SCr,BUN,Cys-C,creatinine and urea were recorded.Relationship between WMIL severity and serum Cys-C level was analyzed by multivariate logistic regression analysis.Results The incidence of DM was significantly higher in moderate WMIL group and severe WMIL group than in mild WMIL group (P＜0.05,P＜0.01).The serum Cys-C level was significantly higher in severe WMIL group than in mild WMIL group and moderate WMIL group (1.7±1.8 mg/L vs 0.7±0.6 mg/L,1.7±1.8 mg/L vs 0.9±0.6 mg/L,P＜0.05).Multivariate logistic regression analysis showed that serum Cys-C level was an independent risk factor for the WMIL severity after adjustment for age,history of hypertension and DM (OR =2.743,95 ％CI:0.497-1.527,P =0.000).Spearman correlation analysis revealed that elevated serum Cys-C level was positively related with the WMIL severity (r=0.344,P=0.000).Conclusion Elevated serum Cys-C level is related with the WMIL severity in very old patients.