急性腔隙性脑梗死患者血清胱抑素C与认知功能的相关性研究

发布时间：2018-03-05 07:13

本文选题：急性腔隙性脑梗死　切入点：胱抑素C　出处：《中国神经精神疾病杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨急性腔隙性脑梗死患者血清胱抑素C(cystatin C,CysC)水平与认知功能的相关性。方法123例住院治疗的小血管病变所致急性腔隙性脑梗死患者根据CysC水平被分为低、中、高三组(各组均为n=41例)。根据认知功能评测分为认知功能正常组(n=64),血管性轻度认知功能障碍(vascular mild cognitive impairment,VaMCI)组(n=36)及血管性痴呆(vascular dementia,VaD)组(n=23)。比较组间血清CysC、估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)、血清肌酐(serum creatinine,Scr)、血脂、空腹血糖、糖化血红蛋白A1C、血压、美国国立卫生研究院卒中量表(NIHSS)评分、简易精神状态量表(MMSE)、阿尔兹海默病评定量表认知分量表(ADAS-cog)、汉密尔顿抑郁量表(HAMD)得分的差异。采用Logistic回归方法分析CysC与认知功能障碍的相关性。结果高水平血清CysC组较中、低水平血清CysC组的MMSE得分更低(21.98±6.08 vs.25.02±4.69 vs.25.10±3.95),ADAS-cog得分更高(17.73±14.23 vs.12.51±10.39 vs.10.67±7.53),差异有统计学意义(P0.05)。随着血清CysC升高,SCr逐渐升高,e GFR逐渐减低(P0.05)。CysC(0.93±0.21 vs.1.10±0.45 vs.1.34±0.58)、MMSE、ADAS-cog在认知正常组、VaMCI组和VaD三组间两两比较差异均具有统计学意义(P0.05),认知损害越重,CysC越高。多元Logistic回归分析显示CysC的回归系数为7.06(P0.05)。结论血清CysC升高是小血管病变所致急性腔隙性脑梗死患者认知功能障碍的危险因素之一,且与认知障碍的严重程度相关。
[Abstract]:Objective to investigate the correlation between serum cystatin cystatin CysC and cognitive function in patients with acute lacunar cerebral infarction. According to the cognitive function evaluation, the patients were divided into normal cognitive function group (n = 64), vascular mild cognitive impairment group (n = 36) and vascular dementia group (vascular dementia vat) group (n = 23). The serum CysCs were estimated by comparing the serum levels of CysC and glomerular filtration. Serum creatinine creatinine, serum creatinine, serum lipids, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, Fasting blood glucose, glycosylated hemoglobin A1C, blood pressure, National Institutes of Health Stroke scale (NIHSS) score, The differences in scores of MMSE, Alzheimer's disease rating scale (AD) and Hamilton Depression scale (Hamd) were analyzed by Logistic regression method. Results compared with the high level serum CysC group, the correlation between CysC and cognitive dysfunction was analyzed by Logistic regression method. The MMSE score of low level CysC group was lower than that of low level CysC group (21.98 卤6.08 vs.25.02 卤4.69 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.25.10 卤3.95 vs.12.51 卤7.53), and the difference was statistically significant (P 0.05). With the increase of serum CysC, SCR increased, the level of GFR decreased gradually, P0.05. CysCine 0.93 卤0.21 vs.1.10 卤0.45 vs.1.34 卤0.58 vs.1.34 卤0.58 MAS-cog in the cognitive normal group and VaD group. The higher the cognitive impairment was, the higher the CysC was. The multiple Logistic regression analysis showed that the regression coefficient of CysC was 7.06 卤P0.050.Conclusion the increase of serum CysC is one of the risk factors of cognitive dysfunction in patients with acute lacunar cerebral infarction caused by small vascular disease. And related to the severity of cognitive impairment.
【作者单位】：浙江大学医学院附属第一医院神经内科浙江大学医学院附属第一医院脑科学协同创新中心;
【基金】：浙江省省部共建项目(项目编号:2016152769)
【分类号】：R743.33

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