【作者】 刘存杰；

【导师】 王大力； 田广利； 陈乃耀；

【作者基本信息】 华北煤炭医学院 ， 内科学， 2008， 硕士

【摘要】 目的:观察脑梗死患者血清半胱氨酸蛋白酶抑制剂C(Cystatin C)的变化,并探讨其临床意义。目前很多研究认为半胱氨酸蛋白酶抑制剂C(Cystatin C)和脑血管发病有关,是阿尔茨海默病和脑出血的诱发因素,国外有研究认为Cystatin C是无症状性脑梗死发病的影响因素。临床脑梗死发病率和致残率都很高,本课题考察半胱氨酸蛋白酶抑制剂C(Cystatin C)与脑梗死的关系,评价Cystatin C在脑梗死病程病情方面应用价值,以便予以临床干预。对象与方法:病历选择均为我院2007年1月～2007年10月期间住院患者84例,男46例,女38例;均符合临床脑梗死诊断标准,并经头颅CT或MRI证实。⑵对照组选自我院同期体检人群76人,男33例,女43例。采用面对面问卷及查阅病历调查形式由研究生本人填写调查表,收集调查对象的一般情况及相关信息。调查同时,搜集抽取健康对照者及住院患者清晨空腹静脉血液标本3ml,分离血清,-20℃冰箱保存,标本搜集完整后一起检测。本实验由我院HIV-Ab实验室采用END POINT仪器,试剂由上海德波生物技术有限公司提供,采用酶联免疫法,酶标仪在490nm波长测定。整理数据,输入计算机,用Excel 2003建库,SPSS(11.5)软件包进行统计分析。各组数据用均数±标准差表示,计量资料用t检验,计数资料用χ2检验或方差分析,对脑梗死与其它各个危险因素进行多因素Logistic回归分析,脑梗死与其它变量的关系用多元逐步回归分析。结果:1.脑梗死组与正常对照组相比,脑梗死组血清半胱氨酸蛋白酶抑制剂C(1.69360±0.603101)mg/L明显低于正常对照组(2.00619±0.679114)mg/L,差异有统计学意义(P=0.002<0.05)。2.分层分析后发现,女性血清半胱氨酸蛋白酶抑制剂C水平稍高于男性,差异无统计学意义(P>0.05)。性别与血清半胱氨酸蛋白酶抑制剂C水平无明显相关(r=0.004),相关无有统计学意义(P=0.96>0.05)。3.血清半胱氨酸蛋白酶抑制剂C水平与年龄呈正相关性(r=0.206),相关有统计学意义(P=0.009<0.05)。4.血清半胱氨酸蛋白酶抑制剂C水平与CHOL、TG无相关性。5.血清半胱氨酸蛋白酶抑制剂C水平与胆红素呈负相关(Cystatin C与DBIL r=-0.168, P=0.034<0.05)。结论:1.脑梗死的发病与半胱氨酸蛋白酶抑制剂C(Cystatin C)可能有关,半胱氨酸蛋白酶抑制剂C(Cystatin C)可能是脑梗死发病的影响因素。2.半胱氨酸蛋白酶抑制剂C(Cystatin C)水平与年龄相关,随年龄增长而升高。3.半胱氨酸蛋白酶抑制剂C(Cystatin C)水平与性别无关。4.血清半胱氨酸蛋白酶抑制剂C水平与CHOL、TG水平无关。5.血清半胱氨酸蛋白酶抑制剂C水平与胆红素呈负相关。更多还原

【Abstract】 Objectives: to observe the changes of serum Cystatin C in patients with cerebral infarction and investigate its clinical significance. many researches considered Cystatin C was related with cerebrovascular disease, and it was a causative factor of Alzheimer disease and brain hemorrhage, some overseas researches considered Cystatin C was a protective factor to asymptomatic cerebral infarction. The disease rate and mutilation rate of clinical cerebral infarction are very high, the aim of this study is to investigate the relationship of Cystatin C and cerebral infarction, evaluate the application value of Cystatin C in condition and course of cerebral infarction, so as to give clinical intervention.Objects and Methods: from January to October in 2007, 84 cerebral infarction in patients diagnosed through CT and (or) MRI were selected, include 46 male and 38 female cases, at the corresponding time period, 76 subjects accepted health examination were selected as control group, include 33 male and 43 female cases. To fill in questionnaires by the method of face to face questionnaire and look up the illness records, collected the general state of health and correlated information of all cases. At the same time, to draw blood 3ml from each person of the two groups, to separate serum, preserved in -20℃refrigerator and determine samples when collection was over. This experiment was carried out in HIV-Ab laboratory, used END POINT instrument, reagents were supplied by Shang-hai De-bo biology technology limited company, samples were determined by method of euzymelinked immunosorbent assay, wavelength was 490nm. To arrange the data and input in computer, establish table by Excel 2003, adopt package SPSS(11.5)to carry out statistical analysis. All data were indicated by mean±standard deviation, measurement data were analyzed by T test, numeration data were analyzed byχ2 test or F test, cerebral infarction and each risk factor were analyzed by multiple factor Logistic regression analysis, the relation of cerebral infarction and other variables were analyzed by multivariant gradual regressive analysis.Result: 1. serum Cystatin C is significantly lower in cerebral infarction group(1.69360±0.603101) compared with control group(2.00619±0.679114), there was statistical significance between the two group(P=0.002<0.05). 2. the level of serum Cystatin C in female objects was higher than male objects, but there was no statistical significance between them(P>0.05).There was no associativity between gender and serum Cystatin C(r=0.004, P=0.96>0.05).3. There was positive correlation between age and serum Cystatin C(r=0.206, P=0.009<0.05).Conclusion:1. Cystain C is possible related to cerebral infarction, Cystain C is a possible infuluential factor to clinical cerebral infarction. 2. There is a positive correlation between age and serum Cystatin C, the level of serum Cystatin C rises along with age. 3. There is no correlation between gender and Cystatin C.更多还原