摘要
背景基底核区出血除可导致神经功能损伤外,还会造成认知障碍。同型半胱氨酸(Hcy)水平升高是心脑血管疾病的危险因素,但其与高血压基底核区出血伴抑郁患者认知功能的关系尚不十分明确。目的探讨血清Hcy水平与高血压基底核区出血伴抑郁患者认知障碍的关系,以为其临床诊疗提供依据。方法选取中国科学院大学深圳医院(光明)神经内科2017年1月—2019年10月收治的高血压基底核区出血伴抑郁患者144例,根据简易智能精神状态检查量表(MMSE)评分分为认知障碍组59例(MMSE评分<27分)和认知正常组85例(MMSE评分≥27分)。比较两组患者临床资料、瘫痪分级及汉密尔顿抑郁量表(HAMD)评分,并采用Pearson相关分析或Spearman秩相关分析高血压基底核区出血伴抑郁患者MMSE评分与出血量、血清Hcy水平、瘫痪分级、HAMD评分的相关性,采用多因素Logistic回归分析高血压基底核区出血伴抑郁患者发生认知障碍的影响因素。结果认知障碍组患者出血量大于认知正常组,血清Hcy水平、HAMD评分高于认知正常组,瘫痪分级重于认知正常组(P<0.05)。相关分析结果显示,高血压基底核区出血伴抑郁患者MMSE评分与出血量、血清Hcy水平、HAMD评分均呈负相关(r值分别为-0.408、-0.564、-0.518,P值均<0.05),与瘫痪分级呈正相关(rs=0.702,P<0.05)。多因素Logistic回归分析结果显示,出血量〔OR=1.841,95%CI(1.146,2.927)〕、血清Hcy水平〔OR=2.793,95%CI(1.046,7.456)〕和瘫痪分级〔OR=2.448,95%CI(1.328,4.522)〕是高血压基底核区脑出血伴抑郁患者发生认知障碍的影响因素(P<0.05)。结论高血压基底核区出血伴抑郁患者血清Hcy水平与其认知功能损伤程度呈负相关,且血清Hcy水平是高血压基底核区出血伴抑郁患者发生认知障碍的影响因素。
Background In addition to neurological impairment,basal ganglia hemorrhage can also lead to cognitive impairment.Elevated homocysteine(Hcy)level is a risk factor for cardiovascular and cerebrovascular diseases,but the correlation between serum Hcy level and cognitive function in patients with hypertensive basal ganglia hemorrhage complicated with depression is unclear.Objective To investigate the relationship between the serum Hcy level and cognitive impairment in patients with hypertensive basal ganglia hemorrhage complicated with depression.Methods 144 patients with hypertensive basal ganglia hemorrhage complicated with depression in Department of Neurology of University of Chinese Academy of Sciences,Shenzhen Hospital(Guangming)from January 2017 to October 2019 were selected,and they were divided into cognitive impairment group(MMSE score<27,n=59)and cognitive normal group(MMSE score≥27,n=85).Clinical data,grade of paralysis and HAMD score were compared between the two groups.Pearson correlation analysis or Spearman rank correlation analysis was used to analyze the correlation between MMSE score and bleeding volume,serum Hcy level,grade of paralysis,HAMD score in patients with hypertensive basal ganglia hemorrhage complicated with depression;multivariate Logistic regression analysis was used to analyze the influencing factors of cognitive impairment in patients with hypertensive basal ganglia hemorrhage complicated with depression.Results The bleeding volume in cognitive impairment group was more than that in cognitive normal group,serum Hcy level,HAMD score in cognitive impairment group were higher than those in cognitive normal group,grade of paralysis in cognitive impairment group was more serious than that in cognitive normal group(P<0.05).Correlation analysis showed that MMSE score was negatively correlated with bleeding volume,serum Hcy level and HAMD score(r value was-0.408,-0.564,-0.518,P<0.05),and positively correlated with grade of paralysis(rs=0.702,P<0.05)in patients with hypertensive basal gangl
作者
寇雨霏
赵华见
王清勇
KOU Yufei;ZHAO Huajian;WANG Qingyong(Department of Neurology,University of Chinese Academy of Sciences,Shenzhen Hospital(Guangming),Shenzhen 518107,China)
出处
《实用心脑肺血管病杂志》
2020年第11期54-58,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
颅内出血
高血压性
抑郁
同型半胱氨酸
认知功能
Intracranial hemorrhage,hypertensive
Depression
Homocysteine
Cognitive function
