Abstract: Objective To investigate the relationship between serum cystatin C (Cys C) and patients with acute ischemic stroke. Methods  The clinical and laboratory data of 115 patients with acute ischemic stroke and 110 controls were recorded and analyzed. Results  The serum Cys C levels of patients in ischemic stroke group [(1.15 ± 0.34) mg/L] were higher than that of the control group [(0.99 ± 0.25) mg/L]. The difference between two groups was significant after correction of age and cardiovascular risk factors (t = ? 3.889, P = 0.000). It was found that age, Cys C, homocysteine (Hcy), type 2 diabetes mellitus [hemoglobin A1c (HbA1c), fructosamine (FRU)], smoking, alcohol consumption, hypertension and intima-media thickness (IMT) were risk factors for ischemic stroke on univariate Logistic regression analysis. The difference of serum Cys C level between the patients and controls was significant (P = 0.000), but through covariance analysis, after adjusted other risk factors, it was not significant (P = 0.875). Conclusion  The serum Cys C levels of patients in ischemic stroke group is higher than the control group. It can be used as an indicator in the acute phase of ischemic stroke. The elevation of serum Cys C is a risk factor for ischemic stroke, but not an independent risk factor.

Key words: Brain ischemia, Stroke, Cysteine proteinase inhibitors, Nephelometry and turbidimetry, Risk factors, Regression analysis

摘要： 目的 探讨血清胱氨酸蛋白酶抑制剂C（胱抑素C）变化与急性缺血性卒中的关系。方法 共纳入115 例急性缺血性卒中患者，记录危险因素并检测血清胱抑素C 变化。结果 急性缺血性卒中患者血清胱抑素C 水平［（1.15 ± 0.34）mg/L］高于对照者［（0.99 ± 0.25）mg/L］，经校正年龄和心血管危险因素后差异具有统计学意义（t = ? 3.889，P = 0.000）。单因素Logistic 回归分析显示，年龄、血清胱抑素C 和同型半胱氨酸、2 型糖尿病（糖化血红蛋白和果糖胺）、吸烟、饮酒、高血压及颈动脉内-中膜厚度为缺血性卒中危险因素，其中以血清胱抑素C 的影响最为显著（P = 0.000），但经协方差分析调整危险因素后与对照组之间差异无统计学意义（P = 0.875）。结论 缺血性卒中患者急性期血清胱抑素C 水平升高为其危险因素之一，可以作为急性期预测指标之一，但并非独立危险因素。

关键词: 脑缺血, 卒中, 半胱氨酸蛋白酶抑制剂, 散射测浊法和比浊法, 危险因素, 回归分析