河北医科大学学报

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血清胱抑素C对急性脑梗死预后的预测价值#br#

  

  1. 承德医学院附属医院神经内科,河北  承德 067000
  • 出版日期:2018-04-25 发布日期:2018-04-23
  • 作者简介:刘宵(1991-),女,河北沧州人,承德医学院附属医院医学硕士研究生,从事神经内科疾病诊治研究。

Predictive value of cystatin C on the prognosis in patients with acute ischemic stroke

  1. Department of Neurology, the Affiliated Hospital of Chengde Medical University, Hebei Prvince, Chengde 067000, China
  • Online:2018-04-25 Published:2018-04-23

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨血清胱抑素C(cystatin C,Cys C)与急性脑梗死预后的相关性及对预后的预测价值。
〖HTH〗方法〖HTSS〗〖KG*2〗回顾性分析264例急性脑梗死患者的临床资料,记录患者相关情况,依据美国国立卫生研究院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)对所有纳入患者进行神经功能缺损评分。依据改良Rankin量表(mddified Rankin Scale,mRS)对所有纳入患者进行神经功能评分,并分为预后良好(mRS评分≤2分)组150例和预后不良(mRS评分>2分)组114例。分别比较不同预后患者的一般资料,并采用Logistic回归分析确定急性脑梗死患者预后不良因素,分析不同严重程度脑梗死患者血清Cys C水平,采用受试者工作特征曲线评价入院时患者血清Cys C水平对急性脑梗死预后的预测价值。
〖HTH〗结果〖HTSS〗〖KG*2〗预后不良组年龄较预后良好组大、心房颤动和脑梗死发生率高于预后良好组。预后不良组血清CysC水平、NIHSS评分较预后良好组高。入院时血清Cys C水平与卒中严重程度呈正相关。多因素Logistic回归分析显示,入院时NIHSS评分、血清Cys C水平、心房颤动病史是预后不良的独立危险因素。入院时血清Cys C水平对急性脑梗死患者预后不良的诊断界值为0.97,敏感度为65.8%,特异度为66.7%,准确度为66.0%。
〖HTH〗结论〖HTSS〗〖KG*2〗入院时血清Cys C水平对急性脑梗死患者预后有良好的预测价值,高血清Cys C水平提示预后不良。

关键词: 脑梗死, 血清胱抑素C, 预后, 危险因素

Abstract: [Abstract] Objective〖HTSS〗〓To investigate the predictive value of cystatin C(Cys C) on the prognosis in patients with acute ischemic stroke.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 264 consecutive patients admitted to the department of neurology, were recruited retrospectively. The clinical characteristics regarding the patients were recorded. Neurologic impairment was assessed based on the National Institutes of Health Stroke Scale(NIHSS). The patients were divided into favorable prognosis group(n=150) and poor prognosis group(n=114), according to the modified Rankin Scale(mRS). The differences of the general characteristics were compared between 2 groups. The multivariate logistic regression analysis was used to analyze the factors of poor prognosis of acute ischemic stroke. The serum Cys C levels in patients with different stroke severity were compared. The receiver operating characteristic curve was used to evaluate the predictive value of Cys C.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Age/the history of atrial fibrillation in patients and the history of ischemic stroke in patients with poor outcome were significantly higher than those in patients with favorable outcome. The level of serum Cys C and NIHSS score in the poor prognosis group were higher than those in the favorable prognosis. The degree of neurological impairment were positively correlated with the serum Cys C. The results of multivariate logistic regression analysis showed that increased NIHSS score, the level of Cys C and the history of atrial fibrillation in patients on admission were independent risk factors for poor prognosis. The optimal critical value of the level of Cys C on admission for the poor prognosis were 0.97. The sensitivity was 65.8%, while the specificity was 66.7%, while the acauracy was 66.0%.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The level of serum Cys C at admission has a good predictive value for the prognosis of patients with acute cerebral infarction. High serum Cys C level suggests poor prognosis.

Key words: brain infarction, cystatin C, prognosis, risk factors