血清神经元特异性烯醇化酶对非痴呆性血管性认知障碍患者进展至血管性痴呆的预测价值  

The predictive value of neuron-specific enolase in vascular dementia be associated with vascular cognitive impairment not dementiapatients

作　　者：刘艳丽[1] 李婷婷[1] 王艳[1] 宋亚君[1] 

机构地区：[1]湖北医药学院附属东风医院检验科,湖北十堰442008

出　　处：《中国医药导报》2017年第4期106-109,122,共5页China Medical Herald

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)水平对非痴呆性血管性认知障碍(VCIND)患者进展至血管性痴呆(Va D)的预测价值。方法前瞻性、连续性队列研究,纳入湖北医药学院附属东风医院于2014年6月14日~2015年10月1日期间初次收治、尚处于VCIND阶段的患者为观察队列,对其进行为期一年的随访以确认预后转归,确诊Va D后,采用修订版简易精神状态检查量表(MMSE-R)评定痴呆程度。分析进展至Va D与未进展至的Va D患者各项临床资料差异性;按基线NSE水平对其进行四分位数分组,使用Logistic回归分析不同NSE水平对于进展至Va D的预测价值;以随访时MMSE-R量表为因变量,以NSE等其他临床指标为自变量,基于多元线性回归分析基线NSE水平对进展至Va D的影响。结果 (1)观察队列中所有患者均至少进行为期一年的随访,最终纳入66患者的临床资料,16例患者于随访期内进展至Va D(实验组)、50例患者于随访期未见病情进展(对照组)。实验组患者的年龄、BMI、吸烟史所占比、TC、NSE均显著高于对照组,其差异均有统计学意义(P<0.05);CPeptide显著低于对照组,差异具有统计学意义(P<0.05)。(2)依照基线NSE水平行四分位分组,单因素Logistic回归分析显示,最高四分位分组进展至Va D的风险是最低四分位分组的1.43倍;通过多因素Logistic回归分析校正其他危险因素后,最高四分位分组进展至VCIND的风险依然为最低四分位分组的1.21倍。(3)多元线性回归显示,基线NSE水平与随访时MMSE-R评分存在显著相关性,依据多元线性回归方程,以一年为随访周期,NSE含量每升高1ng/m L,Va D患者的MMSE-R评分降低0.368分。结论VCIND患者的NSE水平增加是其进展至Va D的独立危险因素,其水平与病情程度存在显著相关性。[AbStract] Objective To explore the predictive value of neuron-specific enolase （NSE） in vascular dementia （VaD） be associated with vascular cognitive impairment not dementia（VCNID）patients. Methods Prospective, cohort cohort study, included in Dongfeng Hospital for the first time between June/14th/2014 to Oetober/lst/2015. Patients who were still in the VCIND phase were followed for a one-year follow-up to confirm the prognosis （MMSE-R） was used to assess the degree of dementia after VaD was diagnosed and the outcome was assessed by the Mini-Mental State Examination （MMSE-R）. The differences of clinical data between VaD and non,progress VaD were analyzed. The patients were divided into four groups according to the baseline NSE level. The logistic regression was used to analyze the predictive value of different NSE levels to progress to VaD as the dependent variable, NSE and other clinical indicators as independent variables, based on multiple linear regression analysis of the baseline level of NSE progress to VaD. Results （1）All the patients in the observation cohort were followed up for at least one year, and the clinical data of 66 patients were included. Sixteen patients progressed to VaD （experimental group） during the follow-up period, 50 patients did not progress in the follow-group）. The age, BMI, smoking history, TC and NSE of the experimental group were significantly higher than those of the control group （P 〈 0.05）; the C-Peptide was significantly lower than the control group, the differ- ence was statistically significant （P 〈 0.05）.（2）Logistic regression analysis showed that the risk of developing VaD to the highest quartile group was 1.43 times that of the lowest quartile group. After adjusting for other risk factors by multivariate Logistic regression analysis, The risk of progressing to VCIND in the highest quartile group was still 1.21 times the lowest quartile.（3）Multiple linear regression analysis showed that the baseline NSE level was significa

关 键 词：血管性痴呆 认知功能 神经元特异性烯醇化酶 

分 类 号：R749.13[医药卫生—神经病学与精神病学]