Zhu Yahui, Huo Yunyun, Bai Jiongming, Li Mao, Wang Hongfen, Wang Jiao, Huang Xusheng
Medical School of Chinese PLA, Beijing, China.
Department of Neurology, the First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China.
Neurol Sci. 2024 Jan;45(1):197-201. doi: 10.1007/s10072-023-06957-9. Epub 2023 Aug 7.
Currently, it is unclear whether serum Cystatin C can be used to evaluate the prognosis of ALS. We aim to study the relationship between serum Cystatin C and survival in ALS.
Sporadic ALS patients diagnosed at the Department of Neurology, the First Medical Center, and the Chinese PLA General Hospital from January 2016 to December 2019 were enrolled in this study. Experienced neurologists followed up the participants regularly every 6 months until January 2022. According to the levels of serum Cystatin C, the participants were divided into high and low Cystatin C levels groups. The comparison between groups was performed with parametric or non-parametric test. Kaplan-Meier method and Cox regression model were used to calculate survival analysis.
Three hundred fifty-six sporadic ALS patients were enrolled in this study, including 203 males and 153 females. Among all ALS patients, 26 cases (7.3%) were lost to follow-up, 226 cases (63.5%) died, and 104 cases (29.2%) were still alive at the last follow-up. The median survival time of all ALS patients was 42.0 months. Patients with high Cystatin C levels had shorter median survival than those with lower Cystatin C levels (38.0 months vs. 48.0 months, P = 2.58 × 10). In multivariate Cox regression analysis, onset form, age of onset, diagnostic delay, disease progression rate, creatinine, and serum Cystatin C levels were associated with ALS survival.
Our study found that serum Cystatin C was associated with ALS survival, and serum Cystatin C level might be an independent predictor of ALS survival.
目前，尚不清楚血清胱抑素C是否可用于评估肌萎缩侧索硬化症（ALS）的预后。我们旨在研究血清胱抑素C与ALS患者生存率之间的关系。
选取2016年1月至2019年12月在中国人民解放军总医院第一医学中心神经内科确诊的散发性ALS患者纳入本研究。由经验丰富的神经科医生每6个月对参与者进行定期随访，直至2022年1月。根据血清胱抑素C水平，将参与者分为胱抑素C水平高、低两组。组间比较采用参数检验或非参数检验。采用Kaplan-Meier法和Cox回归模型进行生存分析。
本研究共纳入356例散发性ALS患者，其中男性203例，女性153例。在所有ALS患者中，26例（7.3%）失访，226例（63.5%）死亡，104例（29.2%）在最后一次随访时仍存活。所有ALS患者的中位生存时间为42.0个月。胱抑素C水平高的患者中位生存期短于胱抑素C水平低的患者（38.0个月 vs. 48.0个月，P = 2.58×10）。多因素Cox回归分析显示，发病形式、发病年龄、诊断延迟、疾病进展速度、肌酐及血清胱抑素C水平与ALS患者的生存相关。
我们的研究发现血清胱抑素C与ALS患者的生存相关，血清胱抑素C水平可能是ALS患者生存的独立预测因素。
