| Background and Objective:Cerebral ischemic stroke is a kinds of diseases which are serious harmful to humanhealth, quality of life and longevity. It is the blood supply to brain disorder by variouscauses, leading to cerebral ischemia, hypoxia necrosis. Cerebral ischemic not only cancause a variety of neurological disorders, but also take a huge burden to individuals,families and society.It is of great significance by early diagnosis, preventive measures,optimal treatment and evaluating prognosis. It was founded that Cystatin C (Cys C) hasthe strongest inhibitory effect on cathepsin recently. Interaction with cathepsin andCys C, maintains the dynamic balance of sedimention and degradation in excellularmatrix. Once the balance is broken,it would accelerate the process ofatherosclerosisThe aim of this study is to found out cystatin C in the role of ischemicstroke, the relationship between Cys C and associated risk factors ,assess the earlydiagnosis of cerebral infarction, prognosis by using Cys C.This study is trying to provideclinical avidence for clinical intervention.Methods:This study selects 115 patients with acute cerebral infarction as experimentalgroup and 110 patients without cerebral infarction as normal control group,fromDecember 2009 to March 2011 at Department of Neurology,the First Affiliated Hospitalof Shantou University Medical College. All patients were undergone cranial MR / CT,carotid artery intima-media thickness testing, Cys c, LDL, LP (a), HCY, UA, HbA1c,fructosamine, and collected clinical data. In this study, SPSS 17.0 software was used forstatistical analysis. Results:1. The serum Cys C levels of patients in cerebral infarction group is higher than thenormal control group, with is statistically significant(P <0.001).2. It is founded that age, Cys C, HCY, 2 diabetes mellitus (HbA1c, fructosamine),smoking, alcohol consumption, hypertension, IMT are risk factors of cerebral infarctionon univariate logistic regression analysis.The level of serum Cys C is significant(P<0.001).3. Through non-conditional multivariate logistic regression analysis,we found thatCys C is a risk factor for cerebral infarction, but not an independent risk factor(P =0.697, OR is 0.552).4. Through covariance analysis adjusting age, uric acid, LDL, LP (a), HCY, HbA1cand fructosamine,we found serum Cys C concentration in cerebral infarction comparedwith the control group was not significant(P = 0.875).It means Cys C leads to cerebralinfarction In the influence of other factors.5. Through age stratified analysis,it showed that the levels of serum Cys C betweencerebral infarction and control groups was statistically significant at the age under 74(P < 0.05),but no significant at the age over 74(P = 0.459).6. Through ANOVA and LDS test,the levels of serum Cys C in different kinds ofradiographic lesions (grouped as normal group, mild lesions group and cerebralinfarction group) are Statistically significant.7. The level of serum Cys C is moderately positively correlated with homocysteine(r = 0.529, P <0.001), low positively correlated with age (r = 0.293, P <0.001), uric acid(r = 0.272, P <0.001) , and is not correlated with fructosamine, LDL and LP (a) .8. The regression equation of serum Cys C: Cys C = 0.025 * HCY +0.008 Age +0.001UA +0.156.9. The area under the ROC curve of Cys C was 0.624(P = 0.034).Its sensitivity is0.420, and specificity is 0.875. Conclusion:1. The serum Cys C levels of patients in cerebral infarction group is higher than thenormal control group, that can be used as indicator in the acute phase of cerebralinfarction;2. The elevation of serum Cys C is a risk factor for cerebral infarction.Theimbalance in cystatin C, with the interation of age, UA, Cys C, HCY, 2 diabetes mellitus(HbA1c, fructosamine ), smoking, alcohol consumption, hypertension and other riskfactors leads to cerebral infarction.3. The levels of serum Cys C in cerebral infarction group was significantly higherthan the control group at the age of over 74;4. Serum Cys C levels and brain imaging was correlated with different degree ofdamage can be used for the detection of lesions and prognosis of discrimination;5. The level of serum Cys C is influenced by age, homocysteine and uric acid.andhas linear relationship with them.6. cystatin C can be used as a clinical examination to diagnosis cerebralinfarction.Its specificity is higher than HCY, UA, IMT.
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