CAJ | 학술논문

目的：研究缺血性脑卒中患者血清胱抑素C与颈动脉粥样硬化的关系。方法应用彩色多普勒显像仪检查163例首发缺血性脑卒中患者的双侧颈总动脉、颈内动脉、颈外动脉，根据颈动脉超声检测结果分为颈动脉内膜中膜厚度（IMT）≥0.9mm及IMT<0.9mm两组，测定患者一般情况及实验室相关生化指标如：血C反应蛋白、同型半胱氨酸、叶酸、维生素B12、尿酸、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白；测定IMT及颈动脉粥样斑块积分。结果（1）与IMT<0.9mm 组相比，IMT≥0.9mm组的血清胱抑素C值明显增高（2.26±1.11）mg/L比（1.02±0.19）mg/L（P<0.001）。（2）在缺血性脑卒中患者中血清胱抑素C 与甘油三酯、低密度脂蛋白、C反应蛋白、同型半胱氨酸、IMT呈显著正相关，与维生素B12呈显著负相关（P<0.05）。（3）颈动脉IMT与各生化指标间的多项式逐步回归分析结果显示，胱抑素C是颈动脉IMT增厚的独立相关因素。结论血清胱抑素C水平与颈动脉血管内膜增厚程度成正相关，可作为临床上早期预测颈动脉粥样硬化发生及程度的指标。
목적：연구결혈성뇌졸중환자혈청광억소C여경동맥죽양경화적관계。방법응용채색다보륵현상의검사163례수발결혈성뇌졸중환자적쌍측경총동맥、경내동맥、경외동맥，근거경동맥초성검측결과분위경동맥내막중막후도（IMT）≥0.9mm급IMT<0.9mm량조，측정환자일반정황급실험실상관생화지표여：혈C반응단백、동형반광안산、협산、유생소B12、뇨산、총담고순、감유삼지、고밀도지단백、저밀도지단백；측정IMT급경동맥죽양반괴적분。결과（1）여IMT<0.9mm 조상비，IMT≥0.9mm조적혈청광억소C치명현증고（2.26±1.11）mg/L비（1.02±0.19）mg/L（P<0.001）。（2）재결혈성뇌졸중환자중혈청광억소C 여감유삼지、저밀도지단백、C반응단백、동형반광안산、IMT정현저정상관，여유생소B12정현저부상관（P<0.05）。（3）경동맥IMT여각생화지표간적다항식축보회귀분석결과현시，광억소C시경동맥IMT증후적독립상관인소。결론혈청광억소C수평여경동맥혈관내막증후정도성정상관，가작위림상상조기예측경동맥죽양경화발생급정도적지표。
ObjectiveTo investigate the relationship of serum cystatin C and carotid atherosclerosis in ischemic stroke patients. MethodsThe color Doppler uhrasonography were used to examined 163 cases of patients with first ischemic stroke in hospital, who’s bilateral common carotid arteries,extracranial of internal carotid artery,according to the results of carotid artery ultrasound test, they were divided into the carotid artery intima-media thickness(IMT)≥0.9mm and IMT<0.9 mm two groups .To test the general condition of patients and the laboratory determination of biochemical indicators such as: Serum levels of C-reactive protein, homocysteine,folic acid,vitamin B12,uric acid,total cholesterol,triglycerides,high -density lipoprotein,low- density lipoprotein;detection of carotid IMT and the plaque score;Results(1)the group of IMT≥0.9mm,the values of serum cystatin C were significantly higher(2.26±1.11mg/L ratio of 1.02±0.19 mg/L,P<0.001)than the group of IMT<0.9mm.(2)the serum cystatin C was significantly positively correlated with triglycerides,low-density lipoprotein,C-reactive protein,Homocysteine and IMT,but has negative correlation with vitamin B12,in Ischemic Stroke Patients(P<0.05;Table 2).(3)Multiple stepwise regression analysis showed that cystatin C(β=0.224,P<0.001)、triglycerides(β=0.154,P=0.025)、Glucose(β=0.059, P=0.031)were the carotid IMT’s independently associated factor(Table 3);ConclusionSerum cystatin C levels is positively correlated with IMT,which can be used an indicators of early prediction of clinical carotid atherosclerosis and extent.