纤维蛋白原与血管性认知功能障碍的关系研究  

Fibrinogen correlates with cognitive impairment in patients with ischemic stroke

作　　者：翟其金[1] 岳炫烨[1] 杨松[1] 吴波娜[1] 徐格林[1] 刘新峰[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)神经内科,南京医学硕士研究生210002

出　　处：《医学研究生学报》2010年第7期725-728,共4页Journal of Medical Postgraduates

基　　金：江苏省自然科学基金(BK2008324)

摘　　要：目的纤维蛋白原(fibrinogen,FIB)与痴呆的发生相关,可能与其作为凝血和炎性因子有关。文中拟探讨在缺血性脑血管病患者中,血浆FIB水平与血管性认知功能障碍(vascular cognitive impairment,VCI)之间的关系,为VCI的防治提供理论依据。方法从南京卒中注册系统中提取符合血管性认知障碍无痴呆型(vascular cognitive impairmentno dementia,VCIND)患者246例,测定血浆FIB水平。将患者分为高FIB组(FIB≥3.0g/L,84例)和正常组(FIB<3.0g/L,162例),运用简易智能状态量表(mini-mental state examination,MMSE)评估患者的认知功能,随访1年半时间,观察患者是否进展为血管性痴呆(vascular dementia,VaD)。结果随访过程中有8例患者死亡,14例患者失访,64例患者进展为VaD;认知功能下降程度与血浆FIB水平呈显著正相关(R=0.293,P<0.001);高FIB水平是VaD的危险因素之一(OR=2.152,95%CI=1.266～3.658)。结论血浆FIB水平与VCI患者认知功能下降程度呈显著相关,血浆高FIB水平增加VCI患者进展为痴呆的风险。Objective Fibrinogen （FIB） is a clotting and inflammatory factor and may be related to the occurrence of dementia.The aim of this study was to investigate the relationship between the level of plasma FIB and vascular cognitive impairment （VCI） in patients with ischemic stroke.Methods We enrolled 246 patients who met the criteria of vascular cognitive impairment,and had no dementia,and measured their plasma FIB levels at admission.Then,based on the levels of plasma FIB,we divided the patients into a high FIB （FIB ≥ 3.0 g/L） and a normal FIB group （FIB 〈3.0g/L）,evaluated their cognitive impairment by Mini-Mental State Examination （MMSE） and followed them up for 18 months for the development of vascular dementia.Results During the follow-up,8 patients died,14 lost touch,and 64 （26.2%） developed dementia.Linear regression analysis indicated a positive correlation of cognitive decline with the plasma FIB level （R = 0.293,P 〈0.001）,with a higher rate of dementia in the high than in the normal FIB group （χ^2 = 5.775,P〈 0.05）.Higher FIB was one of the major risks of vascular dementia （OR = 2.152,95% CI = 1.266-3.658）.Conclusion The level of plasma FIB was significantly correlated with the degree of cognitive decline,and higher FIB increases the risk of dementia in patients with ischemic stroke.

关 键 词：纤维蛋白原 血管性认知功能障碍 卒中 

分 类 号：R338.8[医药卫生—人体生理学]