血清胱抑素c对急性脑梗死患者1年内卒中复发风险的预测价值分析

目的:探讨血清胱抑素C(Cys-C)对急性脑梗死患者1年内卒中复发风险的预测价值。方法:将2016年1月至2017年12月于我院诊治的198例急性脑梗死患者纳入研究,对其进行为期1年的随访,根据患者是否复发将其分为复发组及未复发组,比较两组患者的年龄、性别及基础疾病等一般资料,并对患者Cys-C等相关血清学指标进行比较,采用多因素Logistic回归分析对影响脑梗死复发的因素进行分析,并应用受试者工作曲线(ROC)对上述影响因素预测脑梗死复发的诊断价值及效能进行评估。结果:共有191例患者完成随访,其中有38例患者在1年内脑梗死复发,153例患者未复发;两组患者的年龄、性别、合并基础疾病、吸烟史、家族史及体质量指数(BMI)等一般资料比较差异均无统计学意义(P0.05)。复发组患者低密度脂蛋白(LDL-C)、糖化血红蛋白(Hb A1c)、Cys-C、超敏C反应蛋白(Hs-CRP)及同型半胱氨酸(Hcy)水平明显高于未复发组,差异均有统计学意义(P0.05)。多因素Logistic回归分析显示,高LDL-C、HbA1c、Cys-C及Hcy水平是影响急性脑梗死复发的独立危险因素(OR=12.411,7.527,7.548,1.692;均P0.05)。ROC曲线显示Cys-C预测急性脑梗死复发的AUC为0.853,显著高于LDL-C、HbA1c及Hs-CRP(Z=2.751,3.107,2.895;均P0.05),其诊断的最佳截点为3.56 mg/L,此时其敏感性为76.3%,特异性为83.0%。结论:Cys-C可有效对急性脑梗死患者的1年内卒中复发进行风险评估,具有较高的诊断效能,可用于早期识别脑梗复发高危患者。

Analysis of the Predictive Value of Serum Cystatin C on the Risk of Stroke Recurrence in Patients with Acute Cerebral Infarction within 1 Year

ABSTRACT Objective: To explore the predictive value of serum cystatin C (Cys-C) on the risk of stroke recurrence in patients with acute cerebral infarction within 1 year. Methods: 198 patients with acute cerebral infarction who were diagnosed and treated in our hospital from January 2016 to December 2017 were included in the study. They were followed up for 1 year. According to whether the patients recurrence, they were divided into recurrence group and non recurrence group. The age, gender, basic diseases and other general data of the two groups were compared. The Cys-C and other related serological indicators of the patients were compared. Multivariate Logistic regression analysis was used to analyze the factors influencing the recurrence of cerebral infarction were analyzed, and the diagnostic value and efficacy of these factors in predicting the recurrence of cerebral infarction were evaluated by ROC. Results: A total of 191 patients were followed up, 38 of them had recurrent cerebral infarction within 1 year, 153 had no recurrence. There was no significant difference between the two groups in terms of age, gender, combined basic diseases, smoking history, family history and body mass index (BMI) (P>0.05). The levels of LDL-C, HbA1c, Cys-C, Hs-CRP and Hcy in the recurrence group were significantly higher than those in the non recurrence group (P<0.05). Multivariate Logistic regression analysis showed that high levels of LDL-C, HbA1c, Cys-C and Hcy were independent risk factors for the recurrence of acute cerebral infarction (OR=12.411, 7.527, 7.548, 1.692; all P<0.05). ROC curve showed that the AUC of Cys-C was 0.853, which was significantly higher than LDL-C, HbA1c and Hs-CRP (Z=2.751, 3.107, 2.895; all P<0.05).The best diagnostic cut-off point was>3.56 mg/L. At this time, the sensitivity was 76.3%, and the specificity was 83.0%. Conclusion: Cys-C can effectively evaluate the risk of stroke recurrence within 1 year in patients with acute cerebral infarction, and has a high diagnostic efficiency, which can be used to early identify patients with high risk of cerebral infarction recurrence.