血清视锥蛋白样蛋白-1水平与卒中后认知功能障碍的相关性研究

发布时间：2017-12-26 18:43

本文关键词：血清视锥蛋白样蛋白-1水平与卒中后认知功能障碍的相关性研究　出处：《石河子大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探讨卒中后认知功能障碍患者血清视锥蛋白样蛋白-1(VILIP-1)水平及与卒中后认知功能障碍的相关性。方法选取石河子大学第一附属医院神经内科收治的110例脑梗死患者,于卒中后三个月行蒙特利尔认知评分(MOCA)将患者分为认知障碍组和认知正常组,选取同时期健康体检者50例作为对照组,收集患者一般资料,通过酶联免疫吸附法(ELISA)检测各组血清视锥蛋白样蛋白-1水平,比较各组血清视锥蛋白样蛋白-1水平差异;通过相关分析,明确血清视锥蛋白样蛋白-1水平与蒙特利尔认知评分之间的相关性;分析卒中后认知障碍的影响因素;通过绘制受试者工作特征曲线(ROC)分析血清视锥蛋白样蛋白-1水平对卒中后认知障碍的临床诊断价值。结果(1)110例脑梗死患者53例入组认知功能障碍组,57例入组认知功能正常组,卒中后认知障碍的发生率为48.18%;(2)认知功能障碍组血清VILIP-1水平(530.72±72.05 pg/ml)显著高于认知功能正常组(373.41±50.00 pg/ml)及对照组(332.79±92.13 pg/ml),差异有统计学意义(P0.01);(3)Pearson相关分析示,血清VILIP-1水平与MOCA评分呈负相关(r=-0.724,P0.001);(4)二分类Logistic回归分析显示,高血压(OR=10.200,P=0.035)、VILIP-1(OR=1.033,P0.001)与卒中后认知障碍存在回归关系;(5)以VILIP-1水平来判断卒中后认知障碍,ROC曲线下面积为0.939(P0.001),当选取VILIP-1界值为424.527 pg/m L时,其敏感度为90.57%,特异度为94.74%,阳性诊断准确率为94.12%,阴性诊断准确率为91.53%,总诊断准确率为92.72%。结论(1)卒中后认知障碍患者血清视锥蛋白样蛋白-1水平升高,高于卒中后认知正常患者及正常人;(2)血清视锥蛋白样蛋白-1水平与卒中后认知功能水平呈负相关;(3)高血压、血清VILIP-1水平是卒中后认知障碍的独立危险因素,提示降压治疗的重要性;(4)通过血清视锥蛋白样蛋白-1水平评估卒中后认知功能敏感度、特异度较好,可为卒中后认知障碍的临床评估提供参考。
[Abstract]:Objective to investigate the level of conical protein -1 (VILIP-1) in patients with cognitive impairment after stroke and the correlation with cognitive impairment after stroke. Methods 110 cases of cerebral infarction patients in the First Affiliated Hospital of Shihezi University Department of Neurology, stroke in three months after the Montreal cognitive assessment (MOCA) patients were divided into cognitive dysfunction group and cognitive normal group, select the same period 50 cases of healthy persons as control group, to collect general information of patients, by enzyme linked immunosorbent assay (ELISA) cone like protein -1 levels in serum were detected and compared the serum protein level of -1 cone group; through correlation analysis, clear serum cone protein -1 levels and the correlation between the Montreal cognitive assessment; influencing factors of cognitive impairment after stroke analysis; the receiver operating characteristic the curve (ROC) analysis of the clinical diagnostic value of serum amyloid protein -1 cone level on post stroke cognitive impairment. Results (1) in 110 patients with cerebral infarction 53 cases of cognitive dysfunction group, 57 cases in the group with normal cognitive function group, cognitive impairment after stroke incidence rate was 48.18%; (2) cognitive dysfunction group serum VILIP-1 level (530.72 + 72.05 pg/ml) was significantly higher than that of normal cognitive function group (373.41 + 50 pg/ml) and control group (332.79 + 92.13 pg/ml), the difference was statistically significant (P0.01); (3) Pearson correlation analysis showed that serum VILIP-1 levels were inversely correlated with MOCA score (r=-0.724, P0.001); (4) two classification Logistic regression analysis showed that high blood pressure (OR=10.200, P=0.035), VILIP-1 (OR=1.033, P0.001) and post stroke cognitive impairment regression relation; (5) to the level of VILIP-1 to determine the cognitive impairment after stroke, the area under ROC curve was 0.939 (P0.001), when choosing of VILIP-1 value is 424.527 pg/m L, the sensitivity was 90.57%, specificity was 94.74%, positive diagnosis accuracy rate is 94.12%, The accuracy rate of negative diagnosis was 91.53%, and the total diagnostic accuracy was 92.72%. Conclusion (1) increased in serum of patients with cognitive impairment visinin like protein -1 levels after stroke, stroke is higher than that of normal people and patients with normal cognition; (2) the serum protein level of -1 cone and post stroke cognitive function was negatively correlated; (3) hypertension, serum VILIP-1 level is an independent risk factor for stroke after cognitive impairment, suggesting the importance of antihypertensive therapy; (4) -1 to assess the level of cognitive function after stroke with good sensitivity and specificity by serum cone like proteins, to provide reference for the clinical assessment of cognitive impairment after stroke.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.3

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