老年人血管性认知功能障碍与踝臂指数的相关性  

Correlation between vascular cognitive dysfunction and ankle-brachial index in the elderly

作　　者：蒋柏菊 谭敏[1] 胡志兵[1] 戴建武[1] 李翠琼[2] Jiang Baiju;Tan Min;Hu Zhibing;Dai Jianwu;Li Cuiqiong(Department of Neurology,the 12th People's Hospital of Guangzhou,Guangzhou 510000,China;Department of Internal Medicine,the 12th People's Hospital of Guangzhou,Guangzhou 510000,China)

机构地区：[1]广州市第十二人民医院神经内科,510000 [2]广州市第十二人民医院内二科,510000

出　　处：《中国医师杂志》2020年第4期510-513,共4页Journal of Chinese Physician

基　　金：广州市医药卫生科技项目(20171A010290)。

摘　　要：目的探讨踝臂指数(ABI)评价老年人血管性认知功能障碍(VCI)的临床价值。方法选取2016年5月至2018年12月本院神经内科收治的200例老年住院患者,根据简明智能状态检查表(MMSE)和蒙特利尔认知评估评定(MoCA)量表评估患者认知功能,分为认知功能障碍组(n=110)和认知正常组(n=90),分析比较两组的临床资料,观察ABI与MMSE、MoCA、临床指标的相关性,绘制ABI值对老年人VCI预测价值的受试者工作特征(ROC)曲线。结果⑴两组间性别、入院首次空腹血糖值及合并糖尿病、高血压、高脂血症情况比较,差异无统计学意义(P>0.05);两组年龄、LDL-C、脑小血管病史、ABI比较,差异有统计学意义(P<0.05)。⑵Logistic回归分析显示,ABI是影响老年人VCI的相关因素(P<0.01)。⑶Pearson相关性分析显示,老年人MMSE评分与ABI值呈正相关(r=0.887,P<0.01),MoCA评分与ABI值呈正相关(r=0.843,P<0.01)。⑷ABI对老年人VCI预测价值的ROC曲线下面积为0.965±0.01[95%CI(0.945,0.985),P<0.01]。取ABI≤0.9时灵敏度为88.2%,特异度为91.1%,准确度为89.5%,约登指数为0.793。结论⑴ABI是老年人VCI的影响因素,且与患者的认知障碍严重程度呈正相关。⑵ABI对老年人VCI具有较高的预测价值,ABI≤0.9可以作为老年人VCI的预警因子。Objective To investigate the clinical value of ankle-brachial index(ABI)in evaluating vascular cognitive dysfunction(VCI)in the elderly.Methods According to the mini mental state examination(MMSE)and Montreal cognitive assessment(MoCA),200 elderly inpatients from May 2016 to February 2018 in our hospital were selected.MoCA scale was used to evaluate the cognitive function of the patients.The patients were divided into cognitive dysfunction group(n=110)and cognitive normal group(n=90).The clinical data of the two groups were analyzed and compared.The correlation between ABI and MMSE,MOCA and clinical indicators was observed.The receiver operating characteristic(ROC)curve of ABI value to the predictive value of VCI in the elderly was drawn.Results⑴There was no significant difference between the two groups in terms of gender,the first fasting blood glucose value in hospital and the situation of diabetes,hypertension and hyperlipidemia(P>0.05);there was significant difference in age,low-density lipoprotein cholesterol(LDL-C)level,history of small cerebral vessels and ABI between the two groups(P<0.05).⑵Logistic regression analysis showed that ABI was the related factor of VCI in the elderly(P<0.01).⑶Pearson correlation analysis showed that MMSE score was positively correlated with ABI(r=0.887,P<0.01),MOCA score was positively correlated with ABI(r=0.843,P<0.01).⑷The area under ROC curve of ABI prediction value for VCI in the elderly was(0.965±0.01)[95%CI(0.945,0.985),P<0.01].When ABI≤0.9,the sensitivity and specificity were 88.2%,91.1%respectively;the accuracy and the yordan index were 89.5%and 0.793.Conclusions⑴ABI is an influencing factor of VCI in the elderly and is positively correlated with the severity of cognitive impairment in patients.⑵ABI has a high predictive value for VCI of the elderly,and ABI≤0.9 can be used as an early warning factor for VCI of the elderly.

关 键 词：认知功能障碍 脑血管障碍 踝臂指数 相关性分析 老年人 

分 类 号：R749.13[医药卫生—神经病学与精神病学]