缺血性脑卒中后认知功能障碍病人血清胱抑素-C水平变化及其意义

目的 探讨缺血性脑卒中后认知功能障碍病人血清胱抑素C（Cys-C）水平变化及其意义。方法 选择2017年1月~2019年1月收治的缺血性脑卒中79例，其中36例伴认知功能障碍（观察组），43例不伴认知功能障碍（对照组），另选同期健康体检者30例作为正常组。治疗前、治疗后3、7 d检测血清Cys-C浓度。发生缺血性脑卒中后7 d内，使用蒙特利尔认知评估量表评分评估认知功能，总分<26分表示存在认知功能障碍。结果 观察组Cys-C阳性检出率（83.33%，30/36）明显高于对照组（13.95%，6/43；P<0.05）和正常组（10.00%，3/30；P<0.05），而对照组和正常组之间无统计学差异（P>0.05）。观察组血清Cys-C水平（1.68±0.49）mg/L]明显高于对照组（0.89±0.30）mg/L；P<0.05]和正常组（0.76±0.35）mg/L；P<0.05]，而对照组和正常组之间无统计学差异（P>0.05）。观察组治疗后3 d血清Cys-C水平（1.20±0.40）mg/L]较治疗前明显降低（P<0.05），治疗后7 d血清Cys-C水平（0.80±0.25）mg/L]较治疗后3 d明显降低（P<0.05）。结论 血清Cys-C阳性率及水平检测，可作为评估缺血性脑卒中后认知功能障碍的参考指标。

Change of serum level of cystatin C and its meanings in patients with cognitive dysfunction after ischemic stroke

Objective To investigate the change of the serum level of cystatin C (Cys-C) and its meanings in the patients with cognitive dysfunction after ischemic stroke. Methods Of 79 patients with ischemic stroke treated in our hospital from January, 2017 to January, 2019, 36 (group A) had cognitive dysfunction and 43 (group B) not. The serum levels of Cys-C were measured by immunoturbidimetry in these 76 patients and 30 healthy subjects (group C). Results The positive rate of serum Cys-C was significantly higher in group A (83.33%) than those in groups B (13.95%) and C (10.00%) before the treatment (P<0.05). The serum level of Cys-C was significantly higher in group A (1.68±0.49) mg/L] than those in groups B (0.89±0.30) mg/L] and C (0.76±0.35) mg/L] before the treatment (P<0.05). The serum level of Cys-C was significantly higher before the treatment than those 3 and 7 days after the treatment in the patients with cognitive dysfunction (P<0.05). Conclusions The present results suggest that the serum level of Cys-C can be used as a reference index to evaluate the cognitive dysfunction, and therefore the relationship of the serum level with the cognitive dysfunction is worthy of further research in the patients with ischemic stroke.