颈动脉易损斑块和高敏C反应蛋白与腔隙性脑梗死认知障碍的相关性研究  

Relationship of carotid vulnerable plaques and serum hs-CRP level with cognitive impairment in lacunar infarction patients

作　　者：杨兴东[1] 曾一君[2] 唐晓梅[1] 冯研[1] 史冬梅[1] 刘磊[1] 余秋瑾 于逢春[1] Yang Xingdong;Zeng Yijun;Tang Xiaomei;Feng Yan;Shi Dongmei;Liu Lei;Yu Qiujin;Yu Fengchun(Department of Neurology,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)神经内科,100080 [2]北京市丰台医院神经内科

出　　处：《中华老年心脑血管病杂志》2019年第9期922-925,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：海淀医院院级科研基金面上项目(KYM2018006)

摘　　要：目的探讨颈动脉易损斑块和高敏C反应蛋白与腔隙性脑梗死认知障碍的关系。方法选择2017年1月~2018年10月北京市海淀医院神经内科住院治疗的腔隙性脑梗死患者171例,根据蒙特利尔认知评估量表评分分为无认知障碍组86例,认知障碍组85例。2组均接受颈动脉超声检查,对颈动脉易损斑块、高敏C反应蛋白与腔隙性脑梗死认知障碍进行多因素logistic回归分析。结果与无认知障碍组比较,认知障碍组易损斑块比例和高敏C反应蛋白水平明显增高,差异有统计学意义(P<0.05)。多因素回归分析显示,调整年龄和性别后,随着颈动脉易损斑块数目增多和高敏C反应蛋白水平增高,认知障碍患病率明显增多(OR=2.866,95%CI:1.360~6.042,P=0.006;OR=3.373,95%CI:1.356~8.391,P=0.009)。进一步调整高血压、糖尿病、高脂血症、冠心病以及心房颤动等潜在混杂因素后,颈动脉≥2个易损斑块和高敏C反应蛋白第4分位患者认知障碍患病率仍较高(OR=2.870,95%CI:1.339~6.153,P=0.007;OR=3.622,95%CI:1.431~9.169,P=0.007)。结论颈动脉易损斑块数量和高敏C反应蛋白与认知障碍有关。Objective To study the relationship of carotid vulnerable plaques and serum hs-CRP level with cognitive impairment(CI)in lacunar infarction(LI)patients.Methods One hundred and seventy-one LI patients admitted to our hospital from January 2017 to November 2018 were divided into CI-free group(n=86)and CI group(n=85).The patients in two groups underwent carotid ultrasonography.The relationship of carotid vulnerable plaques and serum hs-CRP level with CI was analyzed by multivariate logistic regression analysis.Results The incidence of carotid vulnerable plaques and the serum level of hs-CRP were significantly higher in CI group than in CI-free group(P<0.05).Multivariate logistic regression analysis showed that the incidence of CI increased with the number of carotid vulnerable plaques and the serum level of hs-CRP after adjustment for age and gender(OR=2.866,95%CI:1.360-6.042,P=0.006;OR=3.373,95%CI:1.356-8.391,P=0.009).The incidence of CI was still higher in patients with their carotid vulnerable plaques≥2 and their hs-CRP score≥4 after the further adjustment for hypertension,DM,hyperlipidemia,CHD and AF(OR=2.870,95%CI:1.349-6.153,P=0.007;OR=3.622,95%CI:1.431-9.169,P=0.007).Conclusion The number of carotid vulnerable plaques and serum level of hs-CRP are related with CI in LI patients.

关 键 词：颈动脉疾病 认知障碍 C反应蛋白质 超声检查 

分 类 号：R74[医药卫生—神经病学与精神病学]