Predictive value of homocysteine and blood pressure variability indicators for cognitive impairment in patients with ischemic cerebral small vessel disease
Objective To explore the predictive value of homocysteine(Hey)and blood pressure variability indicators for cognitive impairment in patients with ischemic cerebral small vessel disease.Methods A total of 136 patients diagnosed with ischemic cerebral small vessel disease in the Kailuan Mental Health Center of Kailuan General Hospital from January 2021 to January 2023 were selected as the research subjects.The Montreal cognitive assessment(MoCA)was used to evaluate patients'cognitive function.According to the cognitive function,the patients were divided into cognitively normal group(MoCA score ≥25,n=52)and cognitively impaired group(MoCA score＜25,n=84).The general clinical data of patients in the two groups were compared.The Hey and blood pressure variability indicators[nighttime systolic blood pressure standard deviation(nSSD),nighttime diastolic blood pressure standard deviation(nDSD),daytime systolic blood pressure standard deviation(dSSD),and daytime diastolic blood pressure standard deviation(dDSD)]of all patients were detected.Logistic regression was used to analyze the influencing factors of cognitive impairment in patients with ischemic cerebral small vessel disease.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of Hey and blood pressure variability indicators for cognitive impairment in patients with ischemic cerebral small vessel disease.Results There was no statistically significant difference in age,body mass index,gender,smoking history,drinking history,diabetes history,and coronary heart disease of patients between the cognitively normal group and the cognitively impaired group(P＞0.05).The proportion of patients with hypertension history showed a statistically significant difference between the two groups(P＜0.05).The Hey,nSSD,nDSD,dSSD,and dDSD of patients in the cognitively impaired group were significantly higher than those in the cognitively normal group(P＜0.05).The multivariate logistic regression analysis showed that Hey,nSSD,nDSD,dSSD,and dDSD were risk factors for cognitive impairment in patients with ischemic cerebral small vessel disease(P＜0.05).The ROC curve analysis showed that the sensitivities of Hey,nSSD,nDSD,dSSD,dDSD,and their combination for predicting cognitive impairment in patients with ischemic cerebral small vessel disease were 67.86％,80.95％,61.90％,78.57％,65.48％,and 94.05％,respectively;the specificities were 78.85％,67.31％,94.23％,88.46％,82.69％,and 96.15％,respectively;and the areas under the curve were 0.778,0.772,0.835,0.893,0.810,and 0.977,respectively.The predictive value of the combined Hey,nSSD,nDSD,dSSD,and dDSD was higher than that of each indicator alone(P＜0.05).Conclusion The Hey,nSSD,nDSD,dSSD,and dDSD in patients with ischemic cerebral small vessel disease who experience cognitive impairment increase,and which have predictive value for the occurrence of cognitive impairment in patients with ischemic cerebral small vessel disease.The predictive value of the combined five indicators is better than that of individual indicators.
homocysteineblood pressure variability indicatorsischemic cerebral small vessel diseasecognitive impairmentpredictive value
维普
万方数据
