摘要
目的探讨老年脑梗死后血管性认知功能障碍(VCI)的危险因素及与血清同型半胱氨酸(Hcy)、淀粉样蛋白A(SAA)、Tau蛋白的关系。方法我院收治疗的106例老年脑梗死患者,根据是否合并VCI分为VCI组(n=46)及非VCI组(n=60),比较两组临床资料及血清Hcy、SAA、Tau蛋白水平,分析影响老年脑梗死后VCI的危险因素及血清Hcy、SAA、Tau蛋白水平在老年脑梗死患者VCI评估中的应用价值。结果两组年龄、文化程度、高血压病史、糖尿病病史、梗死部位、血管范围、卒中后抑郁症(PSD)发生率比较,差异均有统计学意义(P<0.05);VCI组血清Hcy、SAA、Tau蛋白水平高于非VCI组(P<0.05);文化程度、高血压病史、糖尿病病史、梗死部位、PSD发生均为影响老年脑梗死后VCI的独立危险因素(P<0.05);单独检测及联合检测血清Hcy、SAA、Tau蛋白水平的AUC分别为0.740、0.842、0.774、0.951,均可作为评估老年脑梗死患者VCI的效能指标(P<0.05)。结论老年脑梗死后VCI患者血清Hcy、SAA、Tau蛋白水平异常升高,可作为临床早期筛查指标,而文化水平、高血压、糖尿病病史、梗死部位、PSD均是VCI的发生的独立危险因素。
Objective To explore the risk factors of vascular cognitive impairment(VCI)after cerebral infarction in the elderly and their relationship with serum homocysteine(Hcy),amyloid A protein(SAA)and Tau protein.Methods One hundred and six elderly patients with cerebral infarction treated in our hospital were divided into a VCI group(n=46)and a non-VCI group(n=60)according to whether they were combined with VCI.The clinical data and the levels of serum Hcy,SAA,and Tau protein of the two groups were compared.The risk factors affecting VCI after cerebral infarction in the elderly and the application value of serum Hcy,SAA and Tau protein in the evaluation of VCI in elderly patients with cerebral infarction were analyzed.Results There were significant differences in age,educational level,history of hypertension,history of diabetes,location of infarction,range of blood vessels and incidence of post stroke depression(PSD)between the two groups(P<0.05).The levels of serum Hcy,SAA,and Tau protein in the VCI group were higher than those in the non-VCI group(P<0.05).Educational level,history of hypertension,history of diabetes,location of infarction,and PSD were independent risk factors for VCI in elderly patients with cerebral infarction(P<0.05).The area under the curve(AUC)of ROC curve analysis for the levels of serum Hcy,SAA and Tau protein detected separately and jointly were 0.740,0.842,0.774 and 0.951,respectively,which could be used as efficacy indexes to evaluate the VCI in elderly patients with cerebral infarction(P<0.05).Conclusion The levels of serum Hcy,SAA and Tau protein are abnormally increased in elderly patients with VCI after cerebral infarction.These indexes can be used as early clinical screening indicators.Low educational level,history of hypertension,history of diabetes,location of infarction,and PSD are independent risk factors for the occurrence of VCI.
作者
吴浩
符丽珍
赵勇
苏汇泽
柯维春
WU Hao;FU Li-zhen;ZHAO Yong;SU Hui-ze;KE Wei-chun(The Second Affiliated Hospital, Hainan Medical University, Haikou 570105, China)
出处
《实用医院临床杂志》
2022年第3期9-13,共5页
Practical Journal of Clinical Medicine
基金
海南省自然科学基金面上项目(编号:819MS183)。
