血清胱抑素C与脑小血管病认知功能相关性研究  

Differential diagnostic value of cerebrospinal fluid IFN-γ,PCT and MMP-9 in meningitis infection types

作　　者：赵景茹[1] 李睿 霍甜甜 董立朋[1] 杨宝明 吕彩霞[1] 李尧[1] Zhao Jingru;Li Rui;Huo Tiantian;Dong Lipeng;Yang Baoming;Lyu Caixia;Li Yao(Departmentof Neurology,the Hebei People's Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院,石家庄050051 [2]河北医科大学第四医院

出　　处：《脑与神经疾病杂志》2022年第2期82-86,共5页Journal of Brain and Nervous Diseases

基　　金：河北省医学科学研究重点课题(20180108)。

摘　　要：目的探讨血清胱抑素C与隐袭起病的脑小血管病(CSVD)患者认知功能之间的相互作用。方法首先选取了符合CSVD诊断标准的病例64例,并依据患者MoCA评分的分析结果,将同期CSVD的病例分别归类为认知功能障碍组(39例)及认知功能正常组(25例),与此同时选取了同期32例具有脑血管危险因素及卒中样症状(如头晕、头痛、乏力等),但头颅MRI阴性的患者作为对照组。收集所有已经入组病例患者的临床、血清学、影像学及患者认知相关量表等的分析结果,并对患者血清胱抑素C及相关指标进行多因素Logistic回归分析,进而深入探讨患者血清中的胱抑素C和与CSVD患者认知功能之间的相互关系。结果(1)单因素分析结果发现人体血清胱抑素C、患者高血压病史、BMI及血清同型半胱氨酸水平这四个变量在各组之间具有显著差异(P<0.05);(2)血清胱抑素C的水平与CSVD患者的认知功能缺损密切相关(OR=9.987,95%CI:1.728-57.736,P=0.010),再次调整了其他危险因素后,这种显著的相关性依然是存在统计学意义的;(3)患者血清胱抑素C水平与CSVD病认知障碍患者的视空间与执行功能、计算能力、语言能力及MoCA总分之间呈现负相关。结论患者血清中的胱抑素C与CSVD早期认知功能损害密切相关,很有可能成为导致CSVD患者早期发生认知障碍的独立危险预测因素及潜在的血清学生物标记物,从而为CSVD伴认知功能障碍患者的诊断提供实验依据。Objective To discuss the relationship between the renal function marker-serum Cys C and cerebral small vessel disease(CSVD) associated cognitive dysfunction.Methods According to the MoCA score,a total of 64 patients with CSVD was divided into two group of cognitive impairment(n=39) and normal cognition(n=25).In addition,32 patients with cerebrovascular risk factors and stroke-like symptoms(such as dizziness,headache,fatigue,etc.) but negative cerebral MRI signs were administered into the control group contained.Clinical,serological,and imaging materials were collected to estimate the vascular risk factors and meanwhile Logistic regression analysis of serum cystatin C was implemented,so as to find the relationship between serum cystatin C and cognitive injury in the patients with CSVD.Results(1) The significant statistical diferences could be found in the four indicators of serum cystatin C,history of hypertension,BMI,and homocysteine levels among the three different groups(P<0.05);(2) The serum cystatin C level was associated with cognitive function(OR=9.987,95%CI:1.728-57.736,P=0.010),and by virtue of adjusting for the other risk factors,the association between cystatin C levels and cognitive function was still statistically significant;(3) In the cognitive dysfunctional group,the level of serum cystatin C was negatively related with visual space function,executive function,computational and language ability,and accompanied by MoCA score.Conclusions The level of renal function marker serum cystatin C is associated with cognitive dysfunctional and might be an independent risk factor for cognitive impairment,so as to provide a theoretical basis for the diagnosis and treatment of this disease.

关 键 词：血清胱抑素C 脑小血管病 认知功能 

分 类 号：R743.32[医药卫生—神经病学与精神病学]