摘要
目的探讨急性缺血性脑卒中(AIS)病人血清β2-微球蛋白(β2-MG)、脂蛋白相关磷脂酶A2(Lp-PLA2)与卒中后认知障碍的相关性。方法收集陕西省人民医院神经内科住院的AIS病人,于入院后次日检测空腹血清β2-MG、Lp-PLA2、LDL-C、HDL-C等指标,常规治疗3个月后行MoCA量表评估,并根据评分将病人分为卒中后认知障碍(PSCI)组(MoCA<26分)和认知正常组(PSNCI组)(MoCA≥26分),比较2组临床资料特征,分析PSCI发生的危险因素,绘制ROC曲线分析β2-MG、Lp-PLA2及联合检测对PSCI的预测价值及诊断阈值。结果共入组了符合标准的AIS病人102例,治疗3个月时PSCI的发生率为53.9%(55/102)。PSCI组病人的年龄、高血压比例、教育年限及血清β2-MG、Lp-PLA2水平均高于PSNCI组(P<0.05)。Logistic回归分析显示,血清β2-MG、Lp-PLA2水平升高是PSCI的重要危险因素(P<0.05)。β2-MG、Lp-PLA2及联合检测预测PSCI的AUC分别为0.654、0.790、0.872,敏感度分别为80.0%、78.2%、87.3%,特异度分别为66.0%、74.5%、80.8%。结论AIS病人血清β2-MG、Lp-PLA2水平较高时,卒中后3个月更易发生认知障碍,这两个指标可作为PSCI的预测因子。
Objective To explore the correlation of serumβ2 microglobulin(β2-MG)and lipoprotein-related phospholipase A2(Lp-PLA2)with post-stroke cognitive impairment(PSCI)in the patients with acute ischemic stroke(AIS).Methods The AIS patients hospitalized in the Department of Neurology of Shaanxi Provincial People’s Hospital were recruited.Fasting serum levels ofβ2-MG,Lp-PLA2,low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and other indicators were detected at admission.After 3 months of routine treatment,all the patients were divided into PSCI group(MoCA<26)and normal cognition group(MoCA≥26).Multi-variate Logistic regression analysis was performed to analyze the risk factors of PSCI.Finally,Receiver operating characteristic(ROC)curve analysis was carried out to determine the cut-off potint ofβ2-MG and Lp-PLA2.Results A total of 102 AIS patients were enrolled.The prevalence of PSCI after 3 months of routine treatment was 53.9%(55 cases).The age,the ratio of hypertension,years of education,the serum levels of Lp-PLA2 andβ2-MG of the PSCI group were higher than those of the normal cognition group(P<0.05).Logistic regression analysis showed that serum levels ofβ2-MG,Lp-PLA2 were important risk factors for PSCI(P<0.05).The area under ROC curve ofβ2-MG,Lp-PLA2 and combined detection was 0.654,0.790,0.872,with a sensitivity of 80.0%,78.2%,87.3%,and a specificity of 66.0%,74.5%,80.8%respectively.Conclusions AIS patients with higher serum levels ofβ2-MG,Lp-PLA2 are more likely to occur PSCI 3 months after stroke.These index can be used as the predictors of PSCI.
作者
张美妮
李敏
薛佳婧
杨谦
王涛
ZHANG Mei-ni;LI Min;XUE Jia-jing;YANG Qian;WANG Tao(Xi’an Medical University,Xi’an 710054,China;Department of Neurology,Shaanxi Provincial People’s Hospital,Xi’an 710054,China)
出处
《实用老年医学》
CAS
2022年第1期23-26,共4页
Practical Geriatrics
基金
国家自然科学基金青年基金资助项目(31100787)
陕西省自然科学基础研究计划项目(2017JM8029)
陕西省中医药管理局科研课题(2019zzJC036)。
