Lindholt J S, Erlandsen E J, Henneberg E W
Departments of Vascular Surgery and Clinical Biochemistry, Viborg-Kjellerup County Hospital, Viborg, Denmark.
Br J Surg. 2001 Nov;88(11):1472-5. doi: 10.1046/j.0007-1323.2001.01911.x.
The cysteine protease inhibitor cystatin C may play a role in the development and progression of abdominal aortic aneurysms (AAAs).
From a mass screening trial of men aged 65-73 years, 151 small AAAs were followed for a mean of 2.9 years. Of these patients, 142 had serum samples taken to determine the levels of cystatin C, creatinine and C-reactive protein (CRP).
Serum cystatin C concentration correlated negatively with AAA size (r = - 0.22 (95 per cent confidence interval (c.i.) - 0.59 to - 0.02)) and annual expansion rate (r = - 0.24 (95 per cent c.i. - 0.75 to - 0.05)), persisting after adjustment for renal function, smoking, diastolic blood pressure, CRP, age and AAA size. Creatinine clearance and CRP did not correlate with size or expansion rate. Thirty-one AAAs had expanded to over 50 mm, when operation was recommended. The serum level of cystatin C was a significant predictor of this occurrence, with a sensitivity and specificity of 61 and 57 per cent respectively. However, initial AAA size had the optimal sensitivity and specificity (both 81 per cent) in this regard.
Deficiency of cystatin C was associated with increased aneurysm size and expansion rate, possibly due to lack of inhibition of cysteine proteases.
半胱氨酸蛋白酶抑制剂胱抑素C可能在腹主动脉瘤（AAA）的发生和发展中起作用。
在一项针对65 - 73岁男性的大规模筛查试验中，对151个小的腹主动脉瘤进行了平均2.9年的随访。在这些患者中，142例采集了血清样本以测定胱抑素C、肌酐和C反应蛋白（CRP）的水平。
血清胱抑素C浓度与腹主动脉瘤大小呈负相关（r = - 0.22（95%置信区间（c.i.） - 0.59至 - 0.02））和年扩张率（r = - 0.24（95% c.i. - 0.75至 - 0.05）），在对肾功能、吸烟、舒张压、CRP、年龄和腹主动脉瘤大小进行调整后仍然存在。肌酐清除率和CRP与大小或扩张率无关。31个腹主动脉瘤已扩张至超过50 mm，此时建议进行手术。血清胱抑素C水平是这种情况的一个重要预测指标，敏感性和特异性分别为61%和57%。然而，在这方面初始腹主动脉瘤大小具有最佳的敏感性和特异性（均为81%）。
胱抑素C缺乏与动脉瘤大小增加和扩张率增加有关，可能是由于缺乏对半胱氨酸蛋白酶的抑制作用。
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