Department of Neurology, Chongqing Emergency Medical Center, Chongqing University, Chongqing, China.
Department of Neurology, Clinical Medical College, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, China.
Brain Behav. 2021 Feb;11(2):e01969. doi: 10.1002/brb3.1969. Epub 2020 Nov 26.
The relationship between poststroke fatigue (PSF) and serum Cystatin C (Cys-C) levels in hypertensive intracerebral hemorrhage (HICH) patients has not been determined. In this study, we investigated the association between serum Cys-C levels and PSF in HICH patients.
A total of 125 patients with HICH were enrolled. Fatigue assessment was performed 6 months after HICH onset. The presence of PSF was defined as Fatigue Severity Scale (FSS) of 4 or more. Serum Cys-C levels were measured within 24 hr after admission. The correlation between FSS score and Cys-C level was analyzed by Spearman's correlation. Receiver operating characteristic (ROC) curves for PSF were calculated using Cys-C values.
Of enrolled 125 patients in the study, 36.0% who developed PSF were divided to the PSF group, which had higher Cys-C levels compared with the no-PSF group. There was significant positive correlation between FSS score and serum Cys-C level. Receiver operating characteristic curves for PSF revealed an area under the curve of 0.86 for Cys-C. High admission Cys-C (>0.75mg/L) yielded specificity of 93.7%, positive predictive value of 87.5%, and negative predictive value of 88.2%. In multivariate analysis, Cys-C increased by 1 mg/dl (0.1 mg/L), and the risk of PSF in patients increased by 2.55 times (odds ratio = 2.55, 95% CI: 1.65-3.95, p < .001).
High Cys-C levels have predictive value for PSF and can be used as one screening indicator for PSF occurrence.
高血压性脑出血(HICH)患者中风后疲劳(PSF)与血清胱抑素 C(Cys-C)水平之间的关系尚未确定。在这项研究中,我们调查了 HICH 患者血清 Cys-C 水平与 PSF 之间的关系。
共纳入 125 例 HICH 患者。在 HICH 发病后 6 个月进行疲劳评估。PSF 的存在定义为疲劳严重程度量表(FSS)评分≥4 分。入院后 24 小时内测定血清 Cys-C 水平。采用 Spearman 相关分析 FSS 评分与 Cys-C 水平的相关性。用 Cys-C 值计算 PSF 的受试者工作特征(ROC)曲线。
在研究中纳入的 125 例患者中,36.0%发生 PSF 的患者被分为 PSF 组,其 Cys-C 水平高于无 PSF 组。FSS 评分与血清 Cys-C 水平呈显著正相关。PSF 的 ROC 曲线显示 Cys-C 的曲线下面积为 0.86。高入院 Cys-C(>0.75mg/L)的特异性为 93.7%,阳性预测值为 87.5%,阴性预测值为 88.2%。在多变量分析中,Cys-C 增加 1mg/dl(0.1mg/L),患者发生 PSF 的风险增加 2.55 倍(优势比=2.55,95%置信区间:1.65-3.95,p<0.001)。
高 Cys-C 水平对 PSF 具有预测价值,可作为 PSF 发生的筛查指标之一。