The Level Of Serum Cystatin C And Uric Acid In Acute Ischemic Stroke Correlate With Stroke And Prognosis Evaluation

Objective:To investigate the correlation between the level of serum Cystatin C(Cys C)and uric acid(UA)with acute ischemic stroke(AIS),and evaluate their predictive value for prognosis.Method:From January 2016 to December 2016,a total of 264 consecutive patients admitted to the neurological department in affiliated hospital of Chengde Medical University,were recruited retrospectively.And relevant situations of patients were recorded,including ages,sex,the time from onset to admission,past medical history(hypertensive,diabetes,hyperlipemia,atrial fibrillation,cerebral infarction)and personal history(smoke,drink).Partial serum biomarkers were also collected,including Cys C,UA,fasting blood-glucose(FBG),creatinine(Cr),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and highdensity lipoprotein cholesterol(HDL-C).Their clinical manifestation were recorded,and their neural function and disability were assessed according to the National Institutes of Health Stroke Scale(NIHSS)at admission and the modified Rankin scale(mRS)at 3 month after discharge.The patients were divided into good prognosis group(the mRS ?2 scores,n=150)and poor prognosis group(the mRS >2 scores,n=114),according to the scoring criteria of mRS.The differences of the general characteristics were compared between two groups,and the multivariate logistic regression analysis was used to analyze the factors of poor prognosis of AIS.Compared the serum Cys C level and UA level in patients with different severity of cerebral infarction by the analysis method of Spearman.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of Cystatin C and UA for the prognosis of AIS.When P<0.05,the difference was statistically significant.Result:Ages,the scores of NIHSS,the level of Cys C,the history of atrial fibrillation and the history of ischemic stroke in poor prognosis group were significantly much higher than in good prognosis group(all P<0.05).While the level of UA in poor prognosis group was lower than in good prognosis(P<0.05).The results of multivariate logistic regression analysis showed that increased NIHSS score,the level of Cys C at admission were independent risk factors for poor prognosis.While the high level of UA is a protective factor.The degree of neurological impairment was closely related to the level of serum Cys C and UA,positively correlated with the serum Cys C(r=0.310,P<0.05),while negatively correlated with UA(r=-0.220,P<0.001).And the level of serum Cys C was negatively correlated with the level of serum UA(r=-0.133,P<0.05).The optimal critical value of the level of Cys C at admission for the poor prognosis were 0.97.Their sensitivity were 65.8%,while specificity were 66.7%.And the optimal critical value of the level of UA at admission for the good prognosis were 290.7.Their sensitivity were 64.7%,while specificity were 64.9%.Conclusion:The degree of neurological impairment was positively correlated with the level of serum Cys C,while negatively correlated with the level of serum UA.And the level of serum Cys C was negatively correlated with the level of serum UA.The level of serum Cys C and the level of serum UA at admission possess good predictive value of prognosis for the patients with acute ischemic stroke.High Cys C level is associated with poor outcome and high UA level is associated with good outcome.