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目的探讨血浆胱抑素C(CysC)对脑梗死患者静脉溶栓疗效的影响。方法选择2011年7月-2016年8月吉林省舒兰市人民医院住院并接受静脉溶栓治疗的脑梗死患者160例作为研究对象。以血浆CysC含量>1.1mg/L的64例患者为高含量组,≤1.1mg/L的96例患者为低含量组。比较两组患者的疗效,包括美国国立卫生院神经功能缺损量表(NIHSS)评分和不良预后情况。结果低含量组有效率为85.42%显著高于高含量组的75.00%,差异有统计学意义(P<0.05);溶栓前,两组患者的NIHSS评分比较,差异无统计学意义(P>0.05),溶栓1、14、28d后低含量组患者的NIHSS评分低于高含量组,差异有统计学意义(P<0.05);低含量组再发脑梗死、症状性脑出血、非症状性脑出血、死亡等不良预后的发生率明显低于高剂量组,差异有统计学意义(P<0.05)。结论血浆CysC可用来预测脑梗死患者静脉溶栓的疗效,其含量越低,静脉溶栓后的疗效越好,安全性越高。
Objective To investigate the effect of cystatin C (CysC) on the efficacy of intravenous thrombolysis in patients with cerebral infarction. Methods From July 2011 to August 2016, 160 patients with cerebral infarction hospitalized in Shulan People’s Hospital of Jilin Province undergoing intravenous thrombolysis were enrolled. Sixty-four patients with plasma CysC> 1.1 mg / L were high-dose group and 96 patients with ≤1.1 mg / L were low-dose group. Efficacy was compared between the two groups, including the National Institutes of Health neurological deficit scale (NIHSS) score and poor prognosis. Results The effective rate of low-dose group was 85.42%, which was significantly higher than that of high-level group (75.00%, P <0.05). Before the thrombolysis, there was no significant difference in NIHSS scores between the two groups (P> 0.05). NIHSS scores of patients in low content group after 1, 14, and 28 days of thrombolysis were lower than those in high content group (P <0.05); low content of cerebral infarction, symptomatic intracerebral hemorrhage, non-symptom The incidence of adverse prognosis such as cerebral hemorrhage and death was significantly lower than that of the high dose group (P <0.05). Conclusion Plasma CysC can be used to predict the efficacy of intravenous thrombolysis in patients with cerebral infarction. The lower the content of CysC, the better the efficacy after intravenous thrombolysis, the higher the safety.