摘要
目的:分析血清淀粉样蛋白A(SAA)和同型半胱氨酸(Hcy)水平与皮质下缺血性血管病(SIVD)认知损害(CI)的关系。方法:回顾性分析我院152例SIVD患者临床资料,根据其CI发生情况分为非CI组及CI组,比较两组基线资料、血清SAA、Hcy水平及颅内血流动力学指标[大脑中动脉(MCA)-搏动指数(PI)、大脑前动脉(ACA)-PI]差异,使用受试者工作特征曲线(ROC曲线)评估血清SAA、Hcy水平、颅内血流动力学指标对SIVD发生CI的诊断价值,采用Logistic回归模型分析影响SIVD发生CI的危险因素。结果:152例SIVD患者CI组63例(41.45%),非CI组89例(58.55%);两组性别、年龄、吸烟史、饮酒史、高血压及脂代谢紊乱情况比较,差异无统计学意义(P>0.05);CI组受教育年限低于非CI组(P<0.05),糖尿病患病率及血清SAA、Hcy水平、MCA-PI、ACA-PI指数高于CI组(P<0.05)。经ROC曲线分析,血清SAA、Hcy水平及MCA-PI、ACA-PI指数均对SIVD发生CI具有较高诊断价值(AUC=0.859、0.847、0.871、0.666,P<0.05),其cut-off值分别为291.58mg/L、19.77μmoL/L、1.04、0.96。经Logistic回归分析,发现受教育年限<9年、糖尿病、SAA≥291.58mg/L、Hcy≥19.77μmoL/L、MCA-PI≥1.04、ACA-PI≥0.96均为影响SIVD发生CI的独立危险因素(OR=2.113、2.596、2.201、2.151、2.275、1.925,P<0.05)。结论:受教育程度较低及伴糖尿病的SIVD患者发生CI风险较高,血清SAA、Hcy与颅内血流动力学检测对判断SIVD患者发生CI有利,临床应积极监测上述指标,以及时发现CI。
Objective:To analyze the relationship between levels of serum amyloid A(SAA)and homocysteine(Hcy)and cognitive impairment(CI)in subcortical ischemic vascular disease(SIVD).Methods:The clinical data of 152 patients with SIVD in our hospital were retrospectively analyzed.According to the occurrence of CI,they were divided into non-CI group and CI group.The baseline data,levels of serum SAA and Hcy and intracranial hemodynamic indicators[middle cerebral artery(MCA)-pulsatility index(PI),anterior cerebral artery(ACA)-PI]were compared between the two groups.Receiver operating characteristic curve(ROC curve)was used to assess the diagnostic value of serum SAA,Hcy and intracranial hemodynamic indicators on CI in SIVD,and Logistic regression model was used to analyze the risk factors of CI in SIVD.Results:Among 152 patients with SIVD,there were 63 cases(41.45%)in CI group and 89 cases(58.55%)in non-CI group.There were no statistically significant differences between the two groups in terms of gender,age,smoking history,drinking history,hypertension and lipid metabolism disorders(P>0.05).The years of education in CI group was lower than that in non-CI group(P<0.05),and the prevalence rate of diabetes mellitus,serum SAA,Hcy,MCA-PI and ACA-PI were higher than those in CI group(P<0.05).By ROC curve analysis,serum SAA,Hcy,MCA-PI and ACA-PI had high diagnostic value on CI in SIVD(AUC=0.859,0.847,0.871,0.666,P<0.05),and their cut-off values were 291.58 mg/L,19.77μmol/L,1.04 and 0.96 respectively.Logistic regression analysis showed that education<9 years,diabetes mellitus,SAA≥291.58mg/L,Hcy≥19.77μmol/L,MCA-PI≥1.04 and ACA-PI≥0.96 were all independent risk factors for CI in SIVD(OR=2.113,2.596,2.201,2.151,2.275,1.925,P<0.05).Conclusion:SIVD patients with low education level or diabetes mellitus are at higher risk of CI.The detection of serum SAA,Hcy and intracranial hemodynamics is beneficial to determine the occurrence of CI in patients with SIVD.It is necessary to actively monitor the above indicators in clinical prac
作者
周华勇
杨旭
张翼
肖一
季一飞
ZHOU Huayong;YANG Xu;ZHANG Yi(Nanchong Central Hospital / the Second Clinical College of Northern Sichuan Medical College, Sichuan Nanchong 637000, China)
出处
《河北医学》
CAS
2021年第8期1299-1303,共5页
Hebei Medicine
基金
四川省南充市科技局科研项目,(编号:NSMC20170454)。
