The Study On Relationship Between Serum Cystatin C And Acute Cerebral Infarction

Objective: Cerebral infarction refers to cerebral ischemic necrosis caused by cerebral thrombosis or cerebral embolism.Cerebral infarction seriously influence people's health with high morbidity,disability,mortality and recurrence rate,and bring heavy burden to family and society.With cerebral infarction duration prolonged,the rate of disability gradually increased.According to epidemiological studies,Cystatin C(CysC)is a protein recently found which has the strongest inhibiting effect on activity of cathepsin.Many domestic and foreign research indicated that serum CysC was a independent risk factor affecting the cerebral infarction.The purpose of this study was to investigate the relationship between serum Cys C and acute cerebral infarction,and to evaluate its effect on intervention as well as prognosis of cerebral infarction.The research was supposed to provide new ideas for clinical treatment and to improve the prognosis of patients with cerebral infarction.Methods: 128 patients with acute cerebral infarction selected randomly from June 2014 to June 2015 in neurology ward of Ma'anshan Central Hospital by retrospective analysis as observation group.110 patients without acute cerebral infarction selected randomly from the same period in neurology ward of Ma'anshan Central Hospital as control group.Detailed clinical data of patients with acute cerebral infarction were collected and summarized,including gender,age,NIHSS score,history of hypertension,coronary heart disease,diabetes and smoking,levels of lipoprotein a,CysC,C-reactive protein(CRP),bilirubin and uric acid.Serum CysC levels of all research objects were gained by fasting vein blood sampling on second day in the hospital.Statistical analysis and relevant research were carried out on the basis of comparing serum CysC levels between observation group and control group.The measurement data(x±s)were analyzed by two independent sample T-test,while the count data were analyzed by chi square test and logistic regression methods.Differences were statistically significant when P<0.05.Results: The study found that the average serum CysC levels of patients in observation group was(1.02 ± 0.65)mg/L,much higher than(0.67 ± 0.11)mg/L in the control group,mean with while of the difference was significant actually(t=0.573,P=0.012 < 0.05)through two independent sample T-test.Logistic regression analysis on multiple factors related with acute cerebral infarction in observation group showed that the prognosis of patients with acute cerebral infarction were affected by gender,age,hypertension,coronary heart disease,diabetes,smoking history,lipoprotein a.Cysteine protease inhibitor C(CysC),C-reactive protein(CRP),bilirubin and uric acid.Gender was a protective factor,while smoking history(P=0.036,OR=1.56 95,%CI =1.45~1.71),apolipoprotein A(P=0.031,OR=1.46 95%CI =1.14~1.51),Cystatin C(CysC)(P=0.027,OR=1.47 95%CI =1.34~1.61),bilirubin(P=0.024,OR=1.46 95%CI =1.24~1.71)were risk factors.Serum CysC was a independent risk factor for prognosis of cerebral infarction(P=0.027,OR=1.47,95 %CI =1.34~1.61).Conclusion: The level of CysC in patients with acute cerebral infarction were significantly higher than patients without acute cerebral infarction.The index can be used as one marker of acute cerebral infarction and can provide reference value for clinical treatment of acute cerebral infarction.The prognosis of patients with acute cerebral infarction were closely related with gender,age,hypertension,coronary heart disease,diabetes,smoking history,lipoprotein a,Cys C,bilirubin,and uric acid.Gender was regarded as a protective factor,while serum CysC was taken as one of the independent risk factors for the cerebral infarction which had a negative impact on prognosis of patients with acute cerebral infarction.