施正祥　张来萍　刘春艳　何松彬　唐维国温州医科大学附属舟山医院神经内科，浙江舟山　316000

血清胱抑素C对体检人群颈动脉粥样硬化形成的影响

施正祥张来萍刘春艳何松彬▲唐维国
温州医科大学附属舟山医院神经内科，浙江舟山316000

目的探讨体检人群血清胱抑素C（Cys C）水平对颈动脉粥样硬化形成的影响作用。 方法应用彩色多普勒超声检测技术，对体检人员进行双侧颈动脉内膜中层厚度（IMT）测定，根据有无颈动脉粥样硬化将体检者分为颈动脉粥样硬化组和正常对照组，每组各134例。再将颈动脉粥样硬化组根据有无斑块分为斑块组和无斑块组。采用乳胶颗粒增强免疫比浊法（PETIA）检测血清胱抑素C水平及相关生化指标，进行组间比较，分析血清胱抑素C对颈动脉粥样硬化形成的影响作用。结果①颈动脉粥样硬化组血清胱抑素C、胆固醇、低密度脂蛋白、三酰甘油水平均明显高于正常对照组，差异有统计学意义（P＜0.05）。②颈动脉斑块组血清胱抑素C、胆固醇、低密度脂蛋白水平均高于无斑块组，差异有统计学意义（P＜0.05）。③等级相关分析发现：血清胱抑素C水平与颈动脉粥样硬化内膜厚度呈显著相关（P＜0.01）。④多因素Logistic回归分析示高水平血清胱抑素C、年龄是颈动脉粥样硬化斑块形成的危险因素。结论体检人群血清胱抑素C水平与颈动脉粥样硬化形成密切相关，是颈动脉粥样硬化斑块形成的重要危险因素。

血清胱抑素C；颈动脉粥样硬化；体检人群；颈动脉内膜中层厚度

［Abstract］Objective To explore the significance of serum cystatin C（Cys C）levels on carotid atherosclerosis formation in physical examination people.M ethods The technology of color doppler ultrasonography was applied as a physical examinationmeasurement to calculate the bilateral carotid intima-media thickness（IMT）of physical examination people. Carotid atherosclerosis was found in 134 samples.These samples were further divided into two groups according to whether they had atherosclerotic plaque formation.People without carotid atherosclerosiswere considered as the normal control.The level of serum cystatin C and its related biochemical indicators were detected by latex enhanced turbidimetric immunoassay.Statistical analysis was used to investigate the influence of serum cystatin Con carotid artery atherosclerosis formation.Results①The levels of serum Cys C，total cholesterol（TC），low density lipoprotein（LDL）and triglyceride（TG）in the group with thickened carotid intima-media or atherosclerotic plaque were significantly higher than those groupswithout it（P＜0.05）.②The levels of serum Cys C，TC and LDLwere significantly higher in plaque group than the group without plaque（P＜0.05）.③The analysis of spearman rank correlation demonstrated that therewas a significant correlation between the level of Cys C and carotid atherosclerosis intima-media thickness（P＜0.01）.④High Cys C level and age were shown as independent risk factors in the formation of carotid atherosclerotic plaque on Logistic regression analysis.Conclusion Serum cystatin C level is closely related to carotid atherosclerosis in the physical examination people，and it is also a critical risk factor in the formation of carotid atherosclerosis.

［Key words］Serum cystatin C；Carotid atherosclerosis；Physical examination people；Carotid intima-media thickness

研究证实，动脉粥样硬化的发病机制与多种组织蛋白酶的过度表达和相应抑制剂的表达下降相关［1］。……