摘要目的 探讨健康体检人群血清胱抑素C与颈动脉粥样硬化的关系.方法 对2010年1月至2011年12月间在北京协和医院体检中心进行体检的1741名健康体检者(男1193名、女548名)进行分析,排除高血压、糖尿病及肝肾功能不全等慢性病患者.体检项目包括常规体格检查,血胱抑素C及其他生化指标检测,颈动脉彩色超声扫描等.根据颈动脉彩超检查结果将体检者分为颈动脉内膜增厚或斑块形成组及颈动脉内膜正常组,用f检验分析两组血清胱抑素C等生化指标的差异.用Spearman相关分析各指标与颈动脉内膜增厚或斑块形成的关联性.用非条件Logistic回归分析分析颈动脉增厚或斑块形成的相关因素.结果 颈动脉内膜增厚或斑块组的血清胱抑素C高于颈动脉内膜正常组,差异有统计学意义(t=-8.85,P＜0.05),颈动脉内膜中层厚度与血清胱抑素C呈正相关(r =0.21,P ＜0.05),但Logistic回归分析显示,血清胱抑素C增高并不是颈动脉粥样硬化的危险因素.结论 健康体检人群血清胱抑素C与颈动脉粥样硬化关系尚不确定,作为其预测指标尚有待队列研究进一步观察.

abstractsObjectives To evaluate the association between serum cystatin C and carotid atherosclerosis.Methods Medical data,including physical examinations,serum levels of cystatin C,bilirubin,uric acid and other biochemical markers and duplex ultrasonographic scanning for the carotid artery,of 1741 healthy adults (1193 men and 548 women) who sought physical check-up at Peking Union Medical College Hospital during January 2010 and December 2011 were collected,and those with hypertension,diabetes and liver or renal function failure were excluded.Based on the results of carotid duplex uhrasonography,all the adults checked were assigned to two groups,one with thickened intima-media and atherosclerotic plaque (group A),the other with non-thickened intima-media and non-atherosclerotic plaque (group B).Difference in serum cystatin C,bilirubin,uric acid and other biochemical markers between the two groups was analyzed by using Student's t test.The correlation between the markers and carotid plaque was analyzed by using Spearman correlation analysis.The correlated factors of the carotid thickness and plaque appearance were analyzed by using unconditional Logistic regression analysis.Results Serum level of cystatin C was significantly increased in group A (t =-8.85,P ＜ 0.05).Thickness of carotid intima was positively correlated with serum cystatin C (r =0.21,P ＜ 0.05).In multivariate Logistic regression analysis,high level of serum cystatin C was not an independent risk factor of carotid atherosclerosis.Conclusion Relationship between serum cyatatin C and carotid atherosclerosis was not confirmed in our populations,which should be explored further in cohort studies.