踝臂指数与缺血性脑白质病变患者认知功能损害的关系研究  

Relationship Between Ankle Brachial Index and Cognitive Impairment of Patients With Ischemic White Matter Lesions

作　　者：宇辉[1] 张子诚[1] 王为强[1] 张诚[1] 仝德章[1] 

机构地区：[1]安徽医科大学附属宿州市立医院神经内科,安徽省宿州市234000

出　　处：《中国全科医学》2016年第4期418-421,共4页Chinese General Practice

基　　金：国家自然科学基金面上项目(81070877)

摘　　要：目的探讨踝臂指数（ABI）与缺血性脑白质病变（IWML）患者认知功能损害的关系。方法选取于2013年1月—2014年6月到安徽医科大学附属宿州市立医院就诊的IWML患者80例。根据蒙特利尔认知评估（MoCA）量表的评估结果,将其分为认知正常组（n=30）和认知功能损害组（n=50）。比较并分析两组患者的临床资料,绘制ABI对IWML患者认知功能损害预测价值的受试者工作特征（ROC）曲线。结果两组平均年龄和ABI比较,差异有统计学意义（P〈0.05）;两组性别、平均受教育年限、吸烟情况及合并高血压、糖尿病、血脂异常情况比较,差异无统计学意义（P〉0.05）。二分类Logistic回归分析显示,ABI对IWML患者认知功能损害的影响有统计学意义（P〈0.05）。Pearson相关分析显示,ABI与IWML患者的MoCA评分存在正相关关系（r=0.70,P〈0.05）。ABI对IWML患者认知功能损害预测价值的ROC曲线下面积为（0.72±0.06）〔95%CI（0.60,0.84）,P〈0.01〕。当ABI取值为0.81～0.90时,灵敏度为84.0%,特异度为53.3%,总准确度为72.5%。结论 ABI是IWML患者认知功能损害的影响因素,与患者认知功能损害程度存在正相关关系,对IWML患者认知功能损害具有一定预测价值。Objective To explore the association between ankle brachial index（ ABI） and cognitive impairment in patients with ischemic white matter lesions（ IWML）. Methods A total of 80 IWML patients who received treatment in the department of neurology of Suzhou Municipal Hospital Affiliated to Anhui Medical University from January 2013 to June 2014 were enrolled. According to the assessment results of MoCA scale,the patients were divided into two groups： normal cognition group（ n = 30） and impaired cognition group（ n = 50）. Comparison was made between the two groups in clinical data,and ROC curves of the value of ABI in the prediction of impaired cognition were made. Results The two groups were significantly different in average age and ABI（ P 〈0. 05）; the two groups were not significantly different in gender, average education years,smoking status and the complication status of hypertension,diabetes and dyslipidemia（ P 〉0. 05）. Binary logistic regression analysis showed that ABI had significant influence on cognitive impairment（ P 〈0. 05）. Pearson correlation analysis showed that ABI had positive correlation with MoCA score of IWML patients（ r = 0. 70, P 〈0. 05）. AUC of the value of ABI in the prediction of cognitive impairment of IWML patients was（ 0. 72 ± 0. 06） 〔95% CI（ 0. 60,0. 84）,P 〈0. 01〕. When ABI was0. 81～ 0. 90,the sensitivity and specificity were 84. 0% and 53. 3%,with a total accuracy of 72. 5%. Conclusion ABI is an influencing factor for cognitive impairment of IWML patients and has positive correlation with cognitive impairment degree. ABI has predictive value for the cognitive impairment of IWML patients.

关 键 词：脑白质病 踝臂指数 认知障碍 预测 

分 类 号：R742[医药卫生—神经病学与精神病学]