血清SD-LDL hs-CRP Hcy和Lp-PLA2水平与脑小血管病患者认知功能障碍的相关性  

Correlation of serum SD-LDL,hs-CRP,Hcy and Lp-PLA2 levels with cognitive impairment in cerebral small vessel disease patients

作　　者：杨青松[1] 满春露 李柯柯 张晨晨 赵斌[1] 张莹[1] 王娜[1] 贾亚娟[1] YANG Qingsong;MAN Chunlu;LI Keke;ZHANG Chenchen;ZHAO Bin;ZHANG Ying;WAGN Na;JIA Yajuan(The First People’s Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院,河南商丘476100

出　　处：《中国实用神经疾病杂志》2022年第12期1507-1511,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2020年度河南省医学科技攻关计划项目(编号:LHGJ20200926)。

摘　　要：目的分析脑小血管病性认知障碍(CSVCI)的相关影响因素及与认知障碍严重程度的关系,单独或联合检测相关因素对预测CSVCI的临床价值。方法选取2020-09—2022-03商丘市第一人民医院神经内科的脑小血管病(CSVD)患者134例,结合蒙特利尔认知量表(MoCA)评分分为脑小血管病性认知障碍组(CSVCI组)和脑小血管病性认知正常组(CSVCN组)。测定血清小而密低密度脂蛋白(SD-LDL)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)和脂蛋白相关磷脂酶A2(Lp-PLA2),单因素分析初步筛选相关指标,分析相关指标与MoCA评分之间的关系;多因素Logistic回归分析CSVCI的独立影响因素;ROC曲线评估单独及联合检测相关血清学指标预测CVSCI的临床价值。结果CSVCI组和CSVCN组hs-CRP、Lp-PLA2和Hcy比较差异有统计学意义(P<0.05),SD-LDL比较差异无统计学意义(P>0.05)。Pearson相关性分析显示,Lp-PLA2、Hcy、hs-CRP水平与MoCA评分呈负相关(P<0.05),将上述相关指标纳入Logistic多元回归分析,结果显示Hcy、hs-CRP、Lp-PLA2均可能是CSVCI的独立危险因素(P<0.05)。联合检测以上指标的曲线下面积为0.916(0.867~0.965),灵敏度92.30%,特异度79.70%,Youden指数0.720,以上指标P<0.05。结论Lp-PLA2、hs-CRP、Hcy与脑小血管病性认知功能障碍有相关性,SD-LDL可能与脑小血管病性认知功能障碍无相关性,Lp-PLA2、hs-CRP、Hcy水平随着认知功能障碍程度的加重而升高,Lp-PLA2、hs-CRP、Hcy可能是脑小血管病性认知功能障碍的独立危险性因素。联合检测Lp-PLA2、hs-CRP、Hcy水平比单独分别检测以上指标预测CSVCI的临床价值相对更高。Objective To investigate the factors influencing cerebral small vascular cognitive impairment(CSVCI)and the relationship between related factors and the severity of cognitive impairment,and to investigate the clinical diagnostic value of independent or combined detection of related factors in predicting CSVCI for doctors in clinical practice.Methods The study subjects were selected from September 2020 to March 2022,and patients who were treated in the Neurology Ward and Outpatient Department of Shangqiu First People’s Hospital were selected.A total of 134 cases were selected as the subject group.The general basic information and general clinical data were collected in detail.Subjects were scored by the Montreal cognitive scale(MoCA).MoCA score≥26 points into a cognitively normal group,<26 points into a cognitively impaired group,and the cognitive impairment group was set CSVCI group,and the cognitive normal group was set CSVCN group.Serum index was collected and the main selected indicators are small and dense low-density lipoprotein(SD-LDL),high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy)and lipoprotein-associated phospholipase A2(Lp-PLA2).To screen for relevant indicators,a univariate analysis of general clinical data,prior medical history,and laboratory serum index was performed.Pearson correlation test was used to analyze the relationship between correlation indexes and MoCA score.The above indicators were incorporated into the multi-factor Logistic regression model to obtain the independent influencing factors of CSVCI.The ROC curve was utilized to assess the clinical diagnostic value of single and combination detection of related indicators in predicting CVSCI.Results Comparison of CSVCI group and CSVCN group,hs-CRP,Lp-PLA2,and Hcy were significantly different between the two groups(P<0.05),there was no significant difference in SD-LDL between the two groups(P>0.05).Except SD-LDL,there were statistically significant variations between the two groups on hs-CRP,Hcy,Lp-PLA2.The Pearson correla

关 键 词：脑小血管病 认知障碍 小而密低密度脂蛋白 超敏C反应蛋白 同型半胱氨酸 脂蛋白相关磷脂酶A2 血清 

分 类 号：R743[医药卫生—神经病学与精神病学]