缺血性脑白质病变患者认知功能障碍危险因素分析  

Study on risk factors of cognitive dysfunction in patients with ischemic leukoencephalopathy

作　　者：王倩[1] 郑春玲[1] 张艳华[1] 康慧[1] 吴军[2] WANG Qian;ZHENG Chunling;ZHANG Yanhua;KANG Hui;WU Jun(Department of Neurology,Luohe Central Hospital,Luohe,Henan 462000;Department of Neurology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]漯河市中心医院神经内科,河南漯河462000 [2]郑州大学第一附属医院神经内科,郑州450052

出　　处：《郑州大学学报（医学版）》2021年第3期385-389,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191411);漯河医学高等专科学校科技创新项目(一般项目)(2020-LYZKYYB013)。

摘　　要：目的:探讨缺血性脑白质病变患者认知功能障碍的危险因素及尿酸(UA)、血清同型半胱氨酸(Hcy)和低密度脂蛋白胆固醇在疾病中的诊断价值。方法:回顾性收集缺血性脑白质病变患者90例,其中60例存在认知功能障碍者为认知功能障碍组,30例无认知功能障碍者为无认知功能障碍组。通过logistic回归分析缺血性脑白质病变患者认知功能障碍的危险因素,并采用ROC曲线评价相关影响因素在认知功能障碍中的诊断价值。结果:认知功能障碍组血清UA和Hcy水平均高于无认知功能障碍组(P<0.001)。Hcy是缺血性脑白质病变患者发生认知功能障碍的危险因素(OR=1.510,95%CI为1.208~1.888,P<0.001)。血清UA、Hcy、UA+Hcy诊断认知功能障碍的AUC依次为0.727、0.802、0.839,敏感度依次为0.567、0.633、0.733,特异度均为0.867。结论:缺血性脑白质病变患者的血清UA及Hcy水平越高,认知功能障碍程度越高,血清UA和Hcy联合诊断可以预测患者认知功能障碍发展状况。Aim:To explore the risk factors of cognitive dysfunction in patients with ischemic leukoencephalopathy and the diagnostic value of uric acid(UA),serum homocysteine(Hcy)and low-density lipoprotein cholesterol in the disease.Methods:A total of 90 patients with ischemic leukoencephalopathy were collected retrospectively,out of which 60 patients with cognitive dysfunction were in the cognitive dysfunction group,and 30 patients without cognitive dysfunction were in the non-cognitive dysfunction group.Logistic regression was used to analyze the risk factors affecting cognitive dysfunction in patients with ischemic leukoencephalopathy,and the ROC curve was used to evaluate the diagnostic value of the related influencing factors in patients with cognitive dysfunction.Results:Serum UA and Hcy levels in the cognitive dysfunction group were higher than those in the non-cognitive dysfunction group(P<0.001).Hcy was a risk factor for cognitive dysfunction in patients with ischemic leukoencephalopathy(OR=1.510,95%CI was 1.208-1.888,P<0.001).The AUC of serum UA,Hcy,UA+Hcy for the diagnosis of cognitive dysfunction was 0.727,0.802,0.839,the sensitivity was 0.567,0.633,0.733,and the specificity was 0.867.Conclusion:The higher the levels of serum UA and Hcy are in patients with ischemic leukoencephalopathy,the higher the degree of cognitive dysfunction is in patients.Combined diagnosis of serum UA and Hcy could predict the development of cognitive dysfunction.

关 键 词：缺血性脑白质病变 尿酸 同型半胱氨酸 低密度脂蛋白胆固醇 认知功能障碍 

分 类 号：R741[医药卫生—神经病学与精神病学]