| Objective:The purpose of this study is to explore the relationship between carotid atherosclerosis and serum cystatin C(Cys C)and homocysteine(Hcy)in patients with acute cerebral infarction,in order to provide a theoretical basis for evaluating the severity of carotid atherosclerosis and to guide the clinical treatment of acute cerebral infarction.Methods:A total of 198 patients with acute cerebral infarction were enrolled in the Department of Neurology,Xianyang Hospital of Yan'an University from June 2018 to June 2019,and 200 outpatients were selected for physical examination in the same period.The serum Cys C and Hcy levels of the participants were measured according to the specified time and method.The patients were divided into IMT thickening group(58cases)and plaque formation group(140cases),and the case group was divided into mild stenosis group(111cases),moderate stenosis group(55cases),severe stenosis and occlusive group(32cases)according to the carotid artery ultrasound examination of carotid artery IMT(n = 58)and plaque formation group(n = 140,140,140,111,55 and 32cases)according to the standard of carotid artery stenosis,and the patients were divided into mild stenosis group(n = 58),moderate stenosis group(n = 55),severe stenosis group(n = 32)and severe stenosis group(n = 32).According to the nature of plaque,the plaque formation group was divided into stable plaque group(n = 49)and unstable plaque group(n = 91).The differences of serum Cys C and Hcy levels among different groups were compared and analyzed.Pearson analysis was used to analyze the correlation between carotid artery IMT,the degree of carotid artery stenosis and serum Cys C,Hcy.Multivariate Logistic regression was used to analyze the factors affecting the stability of carotid plaque.Results:1.Comparison of general data between the case group and the control group:there was no significant difference in age,sex,body mass index,heart rate,LDL-C,HDL-C,TC and TG between the two groups.The levels of smoking,drinking,systolic blood pressure,diastolic blood pressure and serum Cys C and Hcy in the case group were significantly higher than those in the control group(P<0.05).1.Comparison among subgroups of case group1.1 The serum Cys C levels in carotid IMT thickening group and plaque formation group were(1.16 ±0.43)mg/L and(1.52 ±0.69)mg/L,respectively,and the serum Hcy levels were(19.26 ±1.38)? mol/L and(24.01 ±2.36)? mol/L,respectively.The levels of serum Cys C and Hcy in plaque formation group were higher than those in plaque thickening group.1.2 In patients with acute cerebral infarction,the levels of serum Cys C in mild stenosis group,moderate stenosis group and severe stenosis or occlusion group were(0.91±0.63)mg/L,(1.07±0.69)mg/L and(1.22±0.74)mg/L,respectively.The serum Hcy levels were(17.53±1.98)? mol/L,(22.14±2.15)? mol/L and(25.08 ±2.97)?mol/L,respectively.The levels of serum Cys C and Hcy in severe stenosis or occlusion group were higher than those in moderate stenosis group,and those in moderate stenosis group were higher than those in mild stenosis group.1.3 The levels of serum Cys C in stable plaque group and unstable plaque group were(1.26 ±0.67)mg/L and(1.89 ±0.97)mg/L,respectively.The serum Hcy levels in unstable plaque group were(22.29±4.08)? mol/L and(26.38±3.27)? mol/L,respectively.The levels of serum Cys C and Hcy in unstable plaque group were higher than those in stable plaque group.2.Correlation analysis4.1 In patients with acute cerebral infarction,carotid IMT was proportional to serum Cys C and Hcy(r = 0.516,0.602,P<0.05).4.2 There is a weak correlation between the degree of carotid artery stenosis and serum Cys C and Hcy in patients with acute cerebral infarction(r = 0.205?0.216,P<0.05).5.Multivariate Logistic regression analysis of factors affecting the stability of carotid plaqueMultivariate Logistic regression analysis was performed with the stability of cervical plaque as dependent variable,sex,smoking,drinking,age,BMI,heart rate,HDL,LDL,TC,TG,Cys C,Hcy as independent variables.The results showed that LDL,Cys C and Hcy were independent risk factors for the stability of carotid atherosclerotic plaque.Conclusion:1.There was a positive correlation between carotid IMT and serum Cys C and Hcy levels in patients with acute cerebral infarction.2.The degree of carotid artery stenosis in patients with acute cerebral infarction was weakly correlated with the levels of serum Cys C and Hcy.3.Cys C and Hcy are independent risk factors for the stability of carotid atherosclerotic plaque in patients with acute cerebral infarction. |
PDF Full Text Request