Correlation Between Cystatin C And Cerebral Infarction Caused By Unstable Plaques

Objective:Carotid atherosclerosis is the main cause of cerebral infarction,and there is still no clear mechanism to comprehensively describe it.Lipid and inflammatory theory have been widely supported in recent years.In this study,we mesured the serum Cys C levels respectively in patients with unstable carotid atherosclerotic plaque,cerebral infarction caused by unstable plaque and totally healthy people to investigate the correlation between serum Cys C and cerebral infarction caused by unstable plaques.Methods: A total of 95 patients diagnosed by ultrasound with unstable carotid atherosclerotic plaque in the department of neurology of the people's hospital of shaanxi province from January 2017 to October 2017 were collected,and the patients were divided into two groups namely the cerebral infarction group of 30 cases and the plaque group of 65 cases,in addition,50 cases of normal healthy people as control.After admission,the gender,age,height,weight and the history of smoking hypertension,diabetes and other cerebrovascular risk factors of all the patients were recorded.In the early morning of the second day after admission,blood lipids including triglycerides(TG),low density lipoprotein cholessterol(LDL-C),high density lipoprotein cholessterol(HDL-C),total cholesterol(TC),glycosylated hemoglobin(Hb Alc),uric acid(UA),and other biochemical indicators were detected,and serum cystatin C was detected by immunoturbidimetry(Normal range of serum Cys C: 0.59-1.5mg/L).Statistical analysis was performed using SPSS 19.0 software,setting 0.05 as the inspection level,and P < 0.05 for the difference is statistically significant.Results:(1)The differences among sex,age,smoking history,hypertension history,HDL-C,UA,TG and Hb Alc in the healthy control group,plaque group and cerebral infarction group were not statistically significant(P>0.05).Differences in BMI,TC,LDL-C were statistically significant(P < 0.05).The differences of LDL-C and TC between cerebral infarction group and the control group were statistically significant(P< 0.05),and that of BMI between cerebral infarction group and plaque group had statistically significant(P< 0.05).The difference of LDL-C between control group and plaque group was statistically significant(P< 0.05).(2)The serum Cys C level(3.01+2.93)mg/L in the cerebral infarction group was significantly higher than that in the control group(0.93 + 0.40)mg/L,and the plaque group(1.77 + 0.69)mg/L,and the difference among the three groups was statistically significant(P<0.05).(3)The logistic regression analysis showed that serum Cys C levels and BMI were independent positively correlated with the unstable atherosclerotic plaque and cerebral infarction(OR = 3.394,95% CI: 2.207 ~ 6.575,P < 0.05),BMI(OR = 2.905,95% CI:1.212 ~ 4.354,P < 0.05),indicating that Cys C,BMI are risk factors for cerebral infarction.(4)The value of serum Cys C in predicting cerebral infarction was analyzed by ROC curve.The results showed that the area under the curve of serum Cys C was 0.798(95% CI:0.704-0.874,P < 0.001)),when Cys C was 1.85.The maximum Jordan index was 0.48,its sensitivity and specificity were 76.09% and 71.43%,respectively.It suggested that serum Cys C had good predictive value for cerebral infarction.Conclusions:1.The serum Cys C levels of the patient with carotid atherosclerosis are elevated,and Cys C participates in the formation of AS.2.The serum Cys C of cerebral infarction group is higher than that of the plaque group,and the elevated serum Cys C level may be an independent risk factor for cerebral infarction in patients with carotid atherosclerotic plaque.3.Cys C has a good diagnostic value for cerebral infarction in patients with normal renal function.