老年病人血浆纤维蛋白原与认知功能的关系  

Relationship between plasma fibrinogen and cognitive functions in elderly patients

作　　者：王变荣[1] 张志宇[1] 时建铨[2] WANG Bian- rong ZHANG Zhi-yu SHI Jian-quan(Department of Neurology, Jiangsu Province Geriatric Hospital, Nanfing 210024, China Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China)

机构地区：[1]江苏省老年医院神经内科,江苏省南京市210024 [2]南京医科大学附属南京医院神经内科,江苏省南京市210006

出　　处：《实用老年医学》2017年第3期261-264,共4页Practical Geriatrics

摘　　要：目的探讨老年病人血浆纤维蛋白原(fibrinogen,FIB)水平与认知功能评分的相关性。方法将318例老年病人按照血FIB水平分为2组,正常组180例,血FIB≤3.0 g/L;升高组138例,血FIB>3.0 g/L。采用Addenbrooke改良认知评估量表(Addenbrooke's cognitive examination-revised,ACE-R)及简易智能状态量表(minimental state examination,MMSE)进行认知功能评估。同时分别收集2组病人性别、年龄、受教育程度等基本信息,检测24 h平均血压、血糖、总胆固醇、MMSE评分、ACE-R评分。结果正常组MMSE评分为(25.7±4.4)分,明显高于FIB升高组[(23.2±5.9)分],差异具有统计学意义(P<0.01);正常组和升高组ACE-R评分分别为(73.8±16.6)分和(66.2±22.6)分,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄(OR=4.35,P<0.01)和FIB(OR=2.56,P<0.01)是认知功能减退的危险因素,FIB水平与注意力定向力、记忆、语言评分有相关性,与语言流利性、视空间评分无明显相关性。结论 FIB水平升高是老年病人认知功能减退的危险因素。Objective To investigate the relationship between plasma fibrinogen（ FIB） and cognitive functions in elderly patients. Methods 318 elderly patients were divided into two groups according to the level of FIB,normal-FIB group（ n = 180） with a level of FIB ≤3. 0 g/L and high-FIB group（ n = 138） with a level of FIB 〉3. 0 g/L. Cognitive functions were assessed by Addenbrooke＇s cognitive examination-revised（ ACE-R） and mini-mental state examination（ MMSE）. The general clinical data and serum biochemical indexes were collected. Results The level of FIB was significantly higher in the high-FIB group（ 3. 72 ± 0. 69 g/L） than that in the normal-FIB group（ 2. 45 ± 0. 33 g/L）（ P〈0. 01）. The score of MMSE in the normal-FIB group（ 25. 7±4. 4） was higher than that in the highFIB group（ 23. 2±5. 9）（ P〈0. 01）. ACE-R score was higher in the normal-FIB group（ 73. 8±16. 6） than that in the high-FIB group（ 66. 2±22. 6）（ P〈0. 05）. Logistic regression analysis showed that age（ OR =4. 35,P〈0. 01） and FIB（ OR = 2. 56,P〈0. 01） were risk factors of cognitive function of elderly patients.Conclusions The elevated level of fibrinogen in elderly patients is closely correlated with cognitive functions.

关 键 词：认知功能 纤维蛋白原 Addenbrooke改良认知评估量表 简易智能状态量表 

分 类 号：R749.1[医药卫生—神经病学与精神病学]