同型半胱氨酸、胱抑素C、高密度脂蛋白胆固醇与脑小血管病患者认知障碍的关系
Relationship between homocysteine,cystatin C,high-density lipoprotein cholesterol and cognitive dysfunction in patients with cerebral small vascular disease
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作者信息
- 1. 325000 浙江中医药大学附属温州市中医院神经内科
- 折叠
摘要
目的 探讨同型半胱氨酸(Hcy)、胱抑素C(CysC)、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(MoCA)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、CysC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MoCA评分的相关性.结果 认知障碍组高血压、糖尿病比例以及Hcy、CysC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)、CysC(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、CysC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MoCA评分呈正相关(r=0.362,P=0.004),而Hcy、CysC与MoCA评分均呈负相关(r=-0.410、-0.394,均P＜0.01).结论 HDL-C、Hcy、CysC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.
Abstract
Objective To investigate the relationship between homocysteine(Hcy),cystatin C(CysC),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(MoCA),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 CysC for cognitive impairment in CSVD patients.Pearson correlation was used to assessthe relationship between laboratory indicators and MoCA in CSVD patients with cognitive impairment.Results The hypertension morbidity rate,diabetes morbidity rate,Hcy and CysC 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 CysC(OR=1.178)were independent influencing factors for cognitive impairment in CSVD patients(all P＜0.05).The AUC of HDL-C,Hcy and CysC in evaluating CSVD cognitive dysfunction were 0.723,0.807 and 0.799,respectively.HDL-C was positively correlated with MoCA in CSVD patients(r=0.362,P=0.004),Hcy and CysC were negatively correlated with MoCA(r=-0.410,-0.394,both P＜0.01).Conclusion HDL-C,Hcy and CysC 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.
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Key words
Homocysteine/Cystatin C/High density lipoprotein cholesterol/Cerebral small vascular disease/Cog-nitive dysfunction引用本文复制引用
出版年
2024
NETL
NSTL
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