| Background and Objective:Cerebral ischemic stroke is a kind of disease by the blood supply disorder to brain by extensive and complex causes leading to brain tissue necrosis. Cerebral ischemic stroke not only cause a variety of neurological dysfunction, but also take a great burden to individuals, families and society. Therefore, it is very important for early diagnosis, appropriate preventive measures, the best treatment options and prognosis assessment. In recent years, the study found that Cystatin C is a cysteine protease inhibitor.Generally The vessel wall stability for the normal physiological function is closely related to the homeostasis between the expression of Cystatin C and the secretion of cathepsin and the imbalance of the expression of Cystatin C and the secretion of cathepsin is one of the important reasons for the formation and promotion of atherosclerosis. In this study, the changes of plasma Cystatin C(Cystatin C) levels in patients with acute ischemic stroke and the factors influencing the changes are researched so that it can be provided a way to investigate the role of the mechanism of ischemic stroke.Methods: The study selects the patients with acute ischemic stroke who have a stroke within 48 hours as experimental group further typed according to TOAST classification method and the patients without acute ischemic stroke but with symptom of vertigo as normal control group from January 2013 to December 2014 at Department of Neurology, the Second Affiliated Hospital of Dalian Medical University.All patients wereundergone plasma Cystatin C levels and other routine biochemical tests next morning,and examined through the carotid ultrasonography to measure the carotid artery intima-media thickness and evaluate the carotid artery plaque,and collected the basic clinical data of patients such as age,sex,smoking,drinking,hypertension and relevant risk factors.This study analyze the difference of plasma Cystatin C levels between experimental group and normal control group,and the difference of plasma Cystatin C levels among patients of acute ischemic stroke typed into different subtypes according to TOAST standard,and the relationship between the plasma Cystatin C levels and the possible risk factors of ischemic stroke.The experimental data are analyzed through SPSS17.0 software with the statistical methods of T-test,chi-square test,Pearman rank correlation test,multivariate logistic regression analysis and P<0.05 was considered statistically significant.Results: 1.The plasma Cystatin C levels of patients in acute ischemic stroke group is higher than the normal control group which is(1.33 ± 0.89) VS(1.08 ± 0.25) mg/L and statistically significant(P <0.05). 2. Among the plasma Cystatin C levels of patients of acute ischemic stroke typed into different subtypes according to TOAST standard, the plasma Cystatin C levels of patients in LAA is higher than non-LAA which is(1.53 ± 1.19)VS(1.13 ± 0.34) mg/L and statistically significant(P<0.05). 3. The 76 patients of experimental group and all the normal control group are examined through the carotid ultrasonography,and the plasma Cystatin C levels of patients who have plaque is higher than no plaque which is(1.26 ± 0.77)VS(1.01 ± 0.25) mg/L and statistically significant(P<0.05). 4. In all patients,the difference of age and the ratio of hypertension in patients with high Cystatin C levels are higher than normal Cystatin C levels which is remarkably statistically significant(P <0.01) and the ratio of sex, smoking history, diabetes and dyslipidemia is not statistically significant(P> 0.05). 5.Through Pearman rank correlation test,the levels of plasma Cystatin C is positivelycorrelated with the levels of plasma uric acid(r = 0.305, P <0.01),and is positively correlated with the levels of plasma fibrinogen(r = 0.158, p <0.05), and is not correlated with the carotid artery intima-media thickness measurement, lipids and fasting blood sugar(all P> 0.05). 6. Through multivariate logistic regression analysis, it is founded that Cystatin C is relevant to the risk of occurrence of ischemic stroke besides sex and hypertension, and Cystatin C OR=4.214(95%CI 1.043~17.028, p=0.043).Conclusion: 1.The plasma Cystatin C levels of patients in acute ischemic stroke group is higher than the normal control group and the plasma Cystatin C levels of patients in the acute phase of ischemic stroke can be used as an indicator to type into different subtypes of acute ischemic stroke,and the plasma Cystatin C levels of patients in the LAA group is remarkably higher than non- LAA group. 2.The plasma Cystatin C levels of patients who have carotid atherosclerotic plaques, elderly patients and the patients with hypertension is higher than no plaque group,non-elderly patients and the patients without hypertension. 3.The plasma Cystatin C levels of patients is positively correlated with plasma uric acid and fibrinogen,and not correlated with the carotid artery intima-media thickness,blood lipids,blood glucose. 4.Besides sex and hypertension,high levels of plasma Cystatin C may be a risk factor for ischemic stroke and contribute to the occurrence of acute ischemic stroke. |
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