血清CysC、CD147水平对颅内动脉狭窄支架成形术后再狭窄的预测价值

doi:10.11958/20250634

天津医药 ›› 2025, Vol. 53 ›› Issue (6): 599-603.doi: 10.11958/20250634

血清CysC、CD147水平对颅内动脉狭窄支架成形术后再狭窄的预测价值

张在行(), 汪宁, 张奇, 周静, 郭元展, 裴双, 郭仕乾, 孙军()

南阳市中心医院神经内科脑血管介入病区（邮编467300）

收稿日期:2025-02-18 修回日期:2025-03-26 出版日期:2025-06-15 发布日期:2025-06-20
通讯作者: ^△E-mail：sunjun202202@163.com
作者简介:张在行（1989），男，主治医师，主要从事急性缺血性卒中急诊取栓、脑动脉狭窄介入治疗方面研究。E-mail：15893303973@163.com
基金资助:
河南省科技发展计划项目(232102310198)

The predictive value of serum CysC and CD147 levels for restenosis after intracranial artery stenting in patients with acute ischemic stroke

ZHANG Zaihang(), WANG Ning, ZHANG Qi, ZHOU Jing, GUO Yuanzhan, PEI Shuang, GUO Shiqian, SUN Jun()

Department of Neurology and Cerebrovascular Intervention Ward, Nanyang Central Hospital, Nanyang 467300, China

Received:2025-02-18 Revised:2025-03-26 Published:2025-06-15 Online:2025-06-20
Contact: ^△E-mail: sunjun202202@163.com

张在行, 汪宁, 张奇, 周静, 郭元展, 裴双, 郭仕乾, 孙军. 血清CysC、CD147水平对颅内动脉狭窄支架成形术后再狭窄的预测价值[J]. 天津医药, 2025, 53(6): 599-603.

ZHANG Zaihang, WANG Ning, ZHANG Qi, ZHOU Jing, GUO Yuanzhan, PEI Shuang, GUO Shiqian, SUN Jun. The predictive value of serum CysC and CD147 levels for restenosis after intracranial artery stenting in patients with acute ischemic stroke[J]. Tianjin Medical Journal, 2025, 53(6): 599-603.

摘要/Abstract

摘要：

目的探讨血清胱抑素C（CysC）与单次跨膜糖蛋白147（CD147）对急性缺血性脑卒中（AIS）患者颅内动脉狭窄支架成形术（ICASS）后再狭窄方面的预测价值。方法选取151例接受ICASS的AIS患者为研究组，同期112例健康体检者为对照组。研究组依据ICASS后6个月内再狭窄情况分为再狭窄组（30例）和未狭窄组（121例）。免疫比浊法检测受试者血清CysC水平；酶联免疫吸附试验检测血清CD147水平；多因素Logistic回归分析AIS患者ICASS后再狭窄的影响因素；受试者工作特征（ROC）曲线评估血清CysC、CD147水平对AIS患者ICASS后再狭窄的预测价值。结果研究组患者血清CysC、CD147水平较对照组升高（P<0.01）；再狭窄组狭窄程度>75%的患者占比、血清CysC、CD147水平均高于未狭窄组（P<0.01）；狭窄程度>75%，血清CysC、CD147水平升高是AIS患者ICASS后发生再狭窄的危险因素（P<0.01）；ROC曲线分析显示，血清CysC、CD147水平单独预测AIS患者ICASS后再狭窄的曲线下面积（AUC）分别为0.845、0.850，联合预测的AUC为0.942，联合预测效能明显优于单一指标预测（P<0.05）。结论 AIS患者血清CysC、CD147水平升高是ICASS后发生再狭窄的危险因素，两者联合预测ICASS后颅内动脉再狭窄的效能较高。

关键词: 缺血性卒中, 支架, 半胱氨酸蛋白酶抑制物C, 颅内动脉再狭窄, CD147

Abstract:

Objective To explore the application value of serum cystatin C (CysC) and cluster of differentiation 147 (CD147) in predicting restenosis after intracranial artery stenosis stenting (ICASS) in patients with acute ischemic stroke (AIS). Methods A total of 151 AIS patients who received ICASS were selected as the study group, and 112 healthy individuals who underwent physical examinations during the same period were chosen as the control group. The study group was further divided into the restenosis group (30 cases) and the non-stenosis group (121 cases) based on the restenosis status within 6 months after ICASS. The serum CysC levels of the subjects were detected by immunoturbidimetry, and the serum CD147 levels were measured by enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was conducted to identify factors influencing restenosis after ICASS in AIS patients. The receiver operating characteristic (ROC) curve was used to evaluate the application efficacy of serum CysC and CD147 levels in predicting restenosis after ICASS in AIS patients. Results Serum levels of CysC and CD147 were higher in the study group than those in the control group (P<0.01). The proportion of patients with stenosis degree > 75% and serum levels of CysC and CD147 were higher in the restenosis group than those in the non-stenosis group (P<0.01). The degree of stenosis > 75% and the increased serum levels of CysC and CD147 were risk factors for restenosis after ICASS in AIS patients (P<0.01). ROC curve analysis showed that serum CysC and CD147 levels independently predicted the AUC of AIS patients with restenosis after ICASS were 0.845 and 0.850, respectively, and the combined predicted AUC was 0.942. The combined prediction efficiency was significantly better than that of single indicator prediction (P<0.05). Conclusion The increased levels of serum CysC and CD147 in AIS patients are risk factors for restenosis after ICASS, and the combination of the two is more effective in predicting intracranial artery restenosis after ICASS in AIS patients.

Key words: ischemic stroke, stents, cystatin C, acute ischemic stroke, CD147

中图分类号:

R743

图/表 6

参考文献 20

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组别	n	CysC/（mg/L）	CD147/（ng/L）
对照组	112	0.47±0.09	214.76±45.34
研究组	151	0.89±0.15	439.03±91.15
t		28.114^＊＊	26.183^＊＊

组别	n	CysC/（mg/L）	CD147/（ng/L）
对照组	112	0.47±0.09	214.76±45.34
研究组	151	0.89±0.15	439.03±91.15
t		28.114^＊＊	26.183^＊＊

组别	n		性别（男/女）	年龄/岁	BMI/（kg/m²）		高血压史		糖尿病史	高脂血症		吸烟史		饮酒史
未狭窄组	121		70/51	60.74±10.31	23.08±2.36		45（37.19）		25（20.66）	22（18.18）		44（36.36）		52（42.98）
再狭窄组	30		20/10	61.53±9.25	23.48±2.45		12（40.00）		11（36.67）	7（23.33）		16（53.33）		17（56.67）
t或χ²			0.776	0.383	0.823		0.081		3.392	0.411		2.891		1.816
组别		TC/（mmol/L）		TG/（mmol/L）		LDL-C/（mmol/L）		HDL-C/（mmol/L）			支架数量/个		狭窄程度>75%
未狭窄组		4.29±0.52		1.37±0.17		3.14±0.35		1.30±0.18			1.18±0.39		41（33.88）
再狭窄组		4.45±0.61		1.43±0.20		3.27±0.37		1.24±0.16			1.23±0.43		20（66.67）
t或χ²		1.444		1.642		1.820		1.473			0.638		10.730^＊＊

组别	n		性别（男/女）	年龄/岁	BMI/（kg/m²）		高血压史		糖尿病史	高脂血症		吸烟史		饮酒史
未狭窄组	121		70/51	60.74±10.31	23.08±2.36		45（37.19）		25（20.66）	22（18.18）		44（36.36）		52（42.98）
再狭窄组	30		20/10	61.53±9.25	23.48±2.45		12（40.00）		11（36.67）	7（23.33）		16（53.33）		17（56.67）
t或χ²			0.776	0.383	0.823		0.081		3.392	0.411		2.891		1.816
组别		TC/（mmol/L）		TG/（mmol/L）		LDL-C/（mmol/L）		HDL-C/（mmol/L）			支架数量/个		狭窄程度>75%
未狭窄组		4.29±0.52		1.37±0.17		3.14±0.35		1.30±0.18			1.18±0.39		41（33.88）
再狭窄组		4.45±0.61		1.43±0.20		3.27±0.37		1.24±0.16			1.23±0.43		20（66.67）
t或χ²		1.444		1.642		1.820		1.473			0.638		10.730^＊＊

组别	n	CysC/（mg/L）	CD147/（ng/L）
未狭窄组	121	0.86±0.13	415.46±77.53
再狭窄组	30	1.05±0.14	534.13±80.16
t		7.495^＊＊	7.455^＊＊

血清CysC、CD147水平对颅内动脉狭窄支架成形术后再狭窄的预测价值

The predictive value of serum CysC and CD147 levels for restenosis after intracranial artery stenting in patients with acute ischemic stroke

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变量	β	SE	Wald χ²	P	OR	OR 95%CI
CysC	0.758	0.218	12.105	0.001	1.874	1.393~2.714
CD147	0.903	0.237	14.530	<0.001	2.468	1.551~3.927
狭窄程度	1.139	0.297	14.710	<0.001	3.124	1.745~5.591
常数项	-1.025	0.396	9.057	0.002	0.369

指标	AUC	95%CI	截断值	敏感度/ %	特异度/ %	约登指数
CysC	0.845	0.777~0.898	0.96 mg/L	80.00	82.64	0.626
CD147	0.850	0.783~0.903	471.40 ng/L	80.00	81.82	0.618
二者联合	0.942	0.891~0.973	-	93.33	81.82	0.752

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