摘要
目的 探讨同型半胱氨酸(Hcy)、胱抑素C(Cys C)、高密度脂蛋白胆固醇(HDL-C)与脑小血管病(CSVD)患者认知障碍的关系。方法 回顾性选取2021年8月至2023年6月浙江中医药大学附属温州市中医院收治的119例CSVD患者为研究对象,根据蒙特利尔认知评估量表(Mo CA)评分分为认知障碍组62例,认知正常组57例;比较两组患者临床资料。采用多因素logistic回归分析CSVD患者发生认知障碍的影响因素,采用ROC曲线分析HDL-C、Hcy、Cys C对CSVD患者发生认知障碍的预测效能,采用Pearson相关分析这些实验室指标与CSVD认知障碍患者Mo CA评分的相关性。结果 认知障碍组高血压、糖尿病比例以及Hcy、Cys C水平均高于认知正常组,HDL-C、白蛋白水平均低于认知正常组,差异均有统计学意义(均P<0.05)。高血压(OR=4.221)、糖尿病(OR=3.059)、HDL-C(OR=0.070)、Hcy(OR=1.176)、Cys C(OR=1.178)均是CSVD患者发生认知障碍的独立影响因素(均P<0.05)。HDL-C、Hcy、Cys C预测CSVD患者发生认知障碍的AUC分别为0.723、0.807、0.799。HDL-C与CSVD认知障碍患者Mo CA评分呈正相关(r=0.362,P=0.004),而Hcy、Cys C与Mo CA评分均呈负相关(r=-0.410、-0.394,均P<0.01)。结论 HDL-C、Hcy、Cys C与CSVD患者认知障碍的发生关系密切,可为认知障碍的诊断与防治提供参考。
Objective To investigate the relationship between homocysteine(Hcy), cystatin C(Cys C), high density lipoprotein cholesterol(HDL-C) and cognitive dysfunction in cerebral small vascular disease(CSVD). Methods A retrospective study included 119 patients with CSVD treated at Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from August 2021 to June 2023. According to Montreal cognitive assessment score(Mo CA), 62 patients were cognitively impaired and 57 were cognitively normal, and the clinical data of the two groups were compared. Multivariate logistic regression was used to identify factors influencing cognitive impairment in CSVD patients. ROC curve was used to analyze the predictive efficacy of HDL-C, Hcy and Cys C for cognitive impairment in CSVD patients. Pearson correlation was used to assessthe relationship between laboratory indicators and Mo CA in CSVD patients with cognitive impairment. Results The hypertension morbidity rate, diabetes morbidity rate, Hcy and Cys C levels in the cognition impairment group were higher than those in the normal cognitive group, while HDL-C and albumin levels were lower than those in normal cognitive group(all P<0.05). Hypertension(OR=4.221), diabetes(OR=3.059), HDL-C(OR=0.070), Hcy(OR=1.176) and Cys C(OR=1.178) were independent influencing factors for cognitive impairment in CSVD patients(all P<0.05). The AUC of HDL-C, Hcy and Cys C in evaluating CSVD cognitive dysfunction were 0.723, 0.807 and 0.799, respectively. HDL-C was positively correlated with Mo CA in CSVD patients(r=0.362, P=0.004), Hcy and Cys C were negatively correlated with Mo CA(r=-0.410,-0.394, both P<0.01). Conclusion HDL-C,Hcy and Cys C are closely related to the occurrence of cognitive dysfunction in CSVD patients, it may provide a reference for diagnosis, evaluation and prevention of cognitive impairment.
作者
徐欢欢
陈克龙
黎斌
支海鸯
陈凌
XU Huanhuan;CHEN Kelong;LI Bin;ZHI Haiyang;CHEN Ling(Department of Neurology,Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou 325000,China)
出处
《心电与循环》
2024年第4期358-361,366,共5页
Journal of Electrocardiology and Circulation
基金
温州市科研项目(Y20220219)。
关键词
同型半胱氨酸
胱抑素C
高密度脂蛋白胆固醇
脑小血管病
认知障碍
Homocysteine
Cystatin C
High density lipoprotein cholesterol
Cerebral small vascular disease
Cognitive dysfunction
