The Effect Of Limb Remote Ischemia Conditioning On The Level Of Serum Cystatin C In Patients With Acute Cerebral Infarction

Objective:Observing the level of serum cystatin C (CysC) in patients with acutecerebral infarction,AS well AS the effect of limb remote ischemia conditioning (LRIC)on the level of serum CysC and the degree of neural function defect on those indexesabove.To investigate the relationship between serum CysC level and acute cerebralinfarction and to study the effect and possible pathophysiologic mechanism of LRIC tohe acute cerebral infarction.Methods:51healthy persons as normal-control group and81patients withcerebral infarction as case group coincident with the diagnosis of acute cerebralinfarction.A total132cases of patients match the inclusion and exclusion standard,andtwo groups were comparable in age and gender composition.By contrast researchmethod,the case group were randomly divided into the case-control group(48cases)and LRIC group(33cases), two groups in age gender and severity of ill condition werecomparable.Hitach autobiochemistry instrument was used to measure the level of CysC (byTurbidimetric immunoassay method,mg/L),Urea （by urease UV-rate method， mmol/L),Creatinine（Cre）（by HMMPS method，μmol/L).The changes of above parameters were recorded before and after treatment,aswell as assessed degree of neural function defect with the National Institute of Healthstroke scale（NIHSS）.The first data (before treatment)were marked as “1”and thesecond date (after treatment)were marked as “2”, and “1mius2” was marked as“D-value”.In this study, SPSS20.0software was used for statistical analysis and thesignificance test of the bilateral level was less than0.05(P<0.05).Results:1.The levels of serum CysC before and after treatment in case group（0.993±0.249，0.971±0.256）were significantly higher than that（0.836±0.161）innormal-control group,P<0.01,the difference has statistically significance.The levels ofBUN before and after treatment in case group（5.503±1.372，4.556±1.394）weresignificantly lower than that（5.701±2.438）in normal-control group,but only the levelof after treatment has statistically significance （P<0.01）The level of Cre beforetreatment（63.722±21.067）was higher than that（59.000±13954）and the level of aftertreatment was lower（56.120±16.866）than that in normal-control group,both of themhas no statistically significance.2.The level of serum CysC1in case group has significant positive correlation withNIHSS2（r=0.239，P<0.05）,but no significant correlation with NIHSS1.The level ofserum CysC2in case group has significant positive correlation with NIHSS1（r=0.288,P<0.05）,while no significant correlation was found with NIHSS2.Theserum CysC1has significant positive correlation with the level of BUN1（r=0.459，P<0.01）, but no significant correlation withBUN2.AS well as,the level of serumCysC2has significantly positive correlation with both the level of BUN1and BUN2（r=0.369、0.296，P<0.05）.The serum CysC1has positive correlation with both the level ofCre1and Cre2（r=0.497、0.483,P<0.01）,and the serum CysC2also has positivecorrelation with Cre1and Cre2（r=0.632、0.643，P<0.01）.3.The NIHSS scores before treatment has no significantly difference in case groupand normal-control group.The NIHSS scores after treatment （1.630±2.340，0.610±1.088）were notable lower than before treatment（2.000±2.467，1.180±1.310）both in case-control group and LRIC group（P<0.05，P<0.01）, but the change in LRICgroup was more apparent. The NIHSS difference in LRIC group（0.580±0.663）wassignificantly higher than that（0.290±0.944） in case-control group.4.The levels of serum CysC after treatment（0.972±0.249，0.969±0.272）werelower than before treatment（0.973±0.228，1.019±0.274）both in case-control groupand LRIC group, but the change in LRIC group was more apparent and has statisticallysignificance.The after treatment levels of BUN（4.581±1.254，4.515±1.632）、Cre（57.452±17.226，53.947±16.487） were lower than before treatment BUN（5.343±1.334，5.736±1.415）、Cre（64.031±22.166，63.273±19.687）,and hassignificant discrepancy.But the difference of CysC （0.046±0.065）、 BUN（1.129±1.020）、Cre（10.368±10.243)）in LRIC group was more apparent than thedifference of CysC（0.030±0.742）、BUN（0.829±1.437）、Cre（7.597±9.694）incase-control group.5.During the period of LRIC treatment,there were25cases had slightly pain onthe limb and2cases had slightly headache,all of the discomfortableness wasdisappeared within30mins after the treatment and had no other complaints.Conclusion:1.The level of serum CysC was increased significantly in patients with acute cerebral infarction,and it could reflect the severity of acute cerebral infarction.Itpromoted that CysC might take part in the pathophysiologic mechanism of the acutecerebral infarction.2.LRIC could decrease the level of serum CysC and degree of neural functiondefect significantly.It indicated that LRIC might improve the prognosis of acutecerebral infarction.3. LRIC might improve the renal function.4.LRIC might be a safety and effective treatment of acrte cerebral infarction.