| 摘要: |
| 目的探讨不同分级脑白质疏松症（LA）患者血清胱抑素C（Cys-C）水平及其临床意义。方法按照Fazekas评分标准将83例LA患者分为轻度组24例、中度组32例和重度组27例。收集3组患者的临床资料，检测血清Cys-C水平，并采用蒙特利尔认知评价量表（MoCA）评估认知功能。结果颈动脉内膜中层厚度、患高血压病及腔隙性脑梗死的比例，3组间比较差异均有统计学意义（均P＜0.05）。轻度组、中度组、重度组血清Cys-C水平依次升高，3组间差异均有统计学意义（均P＜0.05）。logistic回归分析显示，血清Cys-C水平是LA严重程度的独立危险因素（OR=2.782；P=0.003）；Spearman相关分析显示，血清Cys-C水平与LA严重程度呈正相关（r=0.351，P=0.001）。轻度组、中度组、重度组MoCA评分依次降低，3组间比较差异均有统计学意义（均P＜0.05）。Spearman相关分析显示，血清Cys-C水平与MoCA总分呈负相关（r=-0.319，P=0.007）；与MoCA各项目中的视空间与执行力、命名、语言、注意与计算力、延迟回忆的评分呈负相关（r=-0.302、-0.265、-0.553、-0.254、-0.239，均P＜0.05）。结论血清Cys-C水平是LA严重程度的独立危险因素，与认知功能障碍有关，对评估不同分级LA病变具有一定价值。 |
| 关键词: 脑白质疏松症 胱抑素 C 脑小血管病 |
| DOI：10.12056/j.issn.1006-2785.2018.40.10.2018-104 |
| 分类号: |
| 基金项目:国家自然科学基金（青年基金项目）（81400986）；“创新强校工程”科研项目（重点培育项目）（4CX14112G）；湛江市科技攻关计划项目（2017B01044） |
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| Clinical significance of serum cystatin C levels in patients with different grades of leukoaraiosis |
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Affiliated Hospital of Guangdong Medical University
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| Abstract: |
| Objective To investigate serum cystatin (Cys-C) levels in patients with different grades of leukoaraiosis (LA) and its clinical significance. Methods According to the Fazekas Scale, the severity of 83 LA patients were classified as mild (n=24), moderate (n=32) and severe (n=27). The clinical data of patients were collected; serum Cys-C levels were detected; the cognitive function was assessed with Montreal Cognitive Assessment Scale (MoCA). Results There were significant differences in the carotid intima-media thickness, prevalence of hypertension and lacunar infarction among three groups(P＜0.05). The levels of serum Cys-C were increased with the increasing of disease severity (P＜0.05). Logistic regression analysis showed that serum Cys-C level was an independent risk factor for the severity of LA (OR=2.782; P=0.003). Spearman rank correlation analysis
showed that serum Cys-C levels were positively correlated with the severity of LA(r=0.351, P=0.001). The levels of MoCA score in mild group, moderate group and severe group increased in turn, there were significant differences among three groups(P＜0.05). Spearman rank correlation analysis showed that serum Cys-C levels were negatively correlated with total MoCA scores (r=-0.
319, P=0.007), and MoCA scores for visual space and executive power, naming, language, attention and computational power, delayed recall (r=-0.302, -0.265, -0.553, -0.254, -0.239, all P＜0.05). Conclusion Serum Cys-C level is an independent risk factor of LA severity, which is related to cognitive impairment and has a certain value in evaluating LA patients of different grades. |
| Key words: Leukoaraiosis Cys-C Cerebral small vessel disease |
