Analysis Of The Relationship Between Cystatin C And Cerebral Infarction

Objective:Ischemic stroke is a cerebral blood supply disorder caused by various reasons,which leads to irreversible damage of local brain tissue. Especially in the acute phase of cerebral apoplexy, the mortality of the patients is the highest due to severe brain edema and brain injury, which brings great burden to the individual, family and society.Therefore, early diagnosis, taking relevant preventive measures and timely and effective treatment is of great significance.Cystatin C(Cys C) was found by Clausen in 1961 in the cerebrospinal fluid(CSF). In recent years, the study found that Cys C was a cysteine protease inhibitor, in vivo interaction with cathepsin, adjusting the balance of the arterial intima of extracellular matrix deposition and degradation. Once the balance is damaged that will promote the process of hardening of the arteries. Some domestic and foreign scholars found that increased Cys C levels increased the risk of cerebral infarction, and Cys C may be an independent risk factor for cerebral infarction. The aim of the study is to investigate the correlation between Cys C and cerebral infarction and the relationship and correlation with other risk factors for ischemic stroke, so that we can judge that whether the Cys C is able to as the basis for the diagnosis of early cerebral infarction, and whether need for clinical intervention and provide more basis for clinical trials.Methods:Review of selected nerve in our hospital department of 2014 July to July 2015 conforms to the diagnosis standard of acute cerebral infarction(onset continued 2 weeks)in 130 cases of patients, non acute phase cerebral infarction(onset > 2 weeks) were 45 cases as experimental group and non cerebral infarction patients hospitalized in the same period in 103 cases as controls. Compare the serum Cys C levels and clinical datas of the three groups and analyse the relationship between cerebral infarction and the Cys C and the correlation between Cys C and other factors. Coronary heart disease, acute myocardial infarction, autoimmune diseases, tumor, grievously, liver and kidney function,acute chronic infection, chronic kidney disease, Rheumatic diseases, trauma, surgery that may influence the serum Cys C levels were excluded. Using SPSS16.0 analysis, the continuous datas employ the mean and standard deviation to describe.The comparisons among the three groups apply the F test, the further comparisons use SNK test.The classification datas use number and rate to describe, and the comparisons among three groups use chi-square test, pairwise comparison use partition of chi-square. The continuous variables are correlated with Pearson, and the categorical variables are analyzed by Spearman rank correlation analysis. The OR value is obtained by two classification of non conditional logistic regression, and the difference is statistically significant with P < 0.05.Results:1. Acute cerebral infarction group and non cerebral infarction group and the control group of the male cases / respectively: 97(74.6%), 30(66.7%), 49(47.6%), the age was 61.77 ± 13.975, 62.69± 11.568, 57.55 ± 14.794, the number of patients having hypertension / respectively: 73(56.2%), 30(66.7%), 36(35%), the number of cases of diabetes / respectively: 31(23.8%),12(26.7%), 8(7.8%), the number of cases with a history of smoking were: 68(52.3%), 25(55.6%), 23(22.3%), the serum LDL values were: 2.786±0.825, 3.013±0.798, 2.503±0.700, the serum HCY were: 22.248±15.460,22.551±1.343, 13.767±4.712, the serum Cys C were 1.236±0.291, 1.083±0.222,0.848+0.182. Gender, age, hypertension, diabetes, smoking, serum LDL, serum HCY,Cys C are different in the three groups, the difference was statistically significant(p<0.05).2. For pairwise comparison, acute cerebral infarction group compare with the control group, gender, age, history of hypertension, history of diabetes, history of smoking,serum low density lipoprotein(LDL), serum Hcy and Cys C are discrepant, the difference is statistically significant(p< 0.05).The non acute cerebral infarction group compare with the control group, gender, age, history of hypertension, history of diabetes,history of smoking, serum low density lipoprotein(LDL), serum Hcy and Cys C are discrepant, the difference is statistically significant(p< 0.05). The acute cerebral infarction group compare with the non acute cerebral infarction group, the serum Cys C values are different and the difference is statistically significant(p< 0.05).3. To Combine the acute stage cerebral infarction group and non acute stage cerebral infarction group into cerebral infarction group. In the cerebral infarction group,there are 127 male cases and the average serum Cys C level 1.207±0.275, there are 48 female cases,and the average serum Cys C level 1.169±0.301. Compare female with male patients serum Cys C levels(t=0.798, p=0.426), the difference is not statistically significant. There are 103 hypertension history cases and the serum Cys C level1.200±0.289, there are 72 cases that had no history of hypertension and the average serum Cys C level 1.193±0.274. Compare to a history of hypertension and non hypertension serum Cys C levels of patients(t=0.149, p=0.882) and the difference is not statistically significant. There are 43 patients that have a history of diabetes and the average serum Cys C level 1.205±0.284, there are 132 patients without a history of diabetes, the average serum Cys C level 1.194±0.282.Compare to with the history of diabetes and without a history of diabetes serum Cys C level(t=0.221, p=0.826), the difference is not statistically significant.There are 93 patients with smoking history and the mean serum levels of cystatin C 1.199±0.273, there are 82 patient without smoking history and the mean serum levels of cystatin C 1.195±0.293. Compare to with a history of smoking and no smoking history serum levels of cystatin C(t=0.103, p=0.918), the differences is no statistical significance. There was no significant difference in the serum level of Cys C between different genders and individuals in the cerebral infarction group.4. By gender, age, hypertension, diabetes, smoking, serum LDL-C, serum HCY and Cys C levels factors as independent variables, to whether suffering from cerebral infarction as dependent variable, multivariate logistic regression analysis. The results show that gender(OR=1.350, 95%CI:0.542~3.366) hypertension(OR=2.577,95%CI:1.230~5.400), diabetes(OR=3.797 95%CI:1.329~10.845), smoking history(OR=2.727 95%CI:1.028~7.234), Cys C levels(OR=2.062 95%CI:1.659~2.563), serum LDL-C(OR=1.857 95%CI:1.157~2.982) and serum HCY(OR=1.09995%CI:1.031~1.171). These are all the risk factors of cerebral infarction. After controlling for other risk factors, the incidence of cerebral infarction was increased by1.062 times per unit of Cys C.5. Serum levels of cystatin C and gender correlation(r=-0.112 p=0.138), and age correlation(r=0.04 p=0.597), and relationship with hypertension(r=0.002 p=0.975), and diabetes correlation(r=0.0001 p=0.997), and smoking correlation(r=-0.051, p = 0.504),and the relationship with LDL-C(r=0.051 p=0.506) and relationship with HCY(r=0.367p<0.0001).Conclusion:1. The increase of serum Cys C level may be a risk factor for cerebral infarction.2.Serum Cys C level was significantly associated with the occurrence of cerebral infarction.3. Cys C level and HCY level was positively.