血清ω3多不饱和脂肪酸水平与脑卒中后认知障碍相关性的回顾性研究  

A retrospective study of correlation between serum levels of omega-3 polyunsaturated fatty acids and poststroke cognitive impairment

作　　者：朱明跃[1] 吴岩峰[2] 李怡阁 姜欣琳 刘元标[1] Zhu Mingyue;Wu Yanfeng;Li Yige;Jiang Xinlin;Liu Yuanbiao(Department of Rehabilitation Medicine,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China;Departmentof Neurology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院康复科,南京210011 [2]南京医科大学第二附属医院神经内科,南京210011

出　　处：《中华物理医学与康复杂志》2023年第2期141-145,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：江苏省卫生健康委医学科研面上项目(M2021064)。

摘　　要：目的回顾性分析血清ω3多不饱和脂肪酸(ω3-PUFAs)与脑卒中后认知障碍(PSCI)的相关性,探讨ω3-PUFAs在辅助诊断与评价PSCI中的应用价值。方法选取2019年1月~2022年3月在南京医科大学第二附属医院康复科、神经内科住院治疗的首次脑卒中患者77例,收集其临床资料,采用简明精神状态量表(MMSE)评分标准将患者分为PSCI组(43例)和非PSCI组(34例),通过病例资料、相关血清ω3PUFAs检验报告,统计分析两组患者血清ω3-PUFAs水平的差异,检验血清ω3-PUFAs主要组成成分α亚麻酸(ALA)、二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)、总值与MMSE评分之间的相关性,探讨PSCI发生的危险因素。结果PSCI组患者的ALA[5.00(3.42,7.56)μmol/L]、EPA[0.50(0.40,0.75)μmol/L]、DHA[2.86(2.11,3.30)μmol/L]、总值[8.93(6.47,10.83)μmol/L]均明显低于非PSCI组,差异有统计学意义(P<0.05);Spearman相关性分析显示血清DHA水平与脑卒中患者的MMSE评分呈弱正相关性(rs=0.320,P<0.05);Logistic回归分析显示血清DHA水平较低是发生PSCI的危险因素(P<0.05,OR=0.554,95%CI为0.368~0.835)。结论PSCI患者的血清ω3-PUFAs水平低于脑卒中后非认知障碍患者,血清DHA水平与MMSE评分呈弱正相关性,较低的血清DHA水平是发生PSCI的独立风险因素,ω3-PUFAs在辅助诊断与评价PSCI方面有较高的应用价值。Objective To quantify any correlation between serum levels of omega-3 polyunsaturated fatty acids(ω3-PUFAs)and post-stroke cognitive impairment(PSCI).Methods The clinical data of 77 patients hospitalized after a first stroke were analyzed.The Minimum Mental State Examination(MMSE)was used to divide them into impaired(PSCI)and unimpaired(non-PSCI)cohorts.The serum levels of ω3-PUFAs,α-linolenic acid(ALA),eieosapentaenoic acid(EPA)and dueosahexenoie acid(DHA)were compared between the two groups and correlated with the individuals'MMSE scores.Results The average ALA,EPA,DHA and total ω3-PUFAs levels of PSCI group were in most cases significantly lower than those of the non-PSCI group.Spearman correlation analysis showed that serum DHA level was a weak positive predictor of the MMSE scores(R=0.32,P≤0.05).Logistic regression analysis indicated that low serum DHA level was an independent risk factor for PSCI(P≤0.01).Conclusions Cognitively impaired stroke survivors tend to have lower serumω3-PUFAs levels than those without cognitive impairment.There is a weak positive correlation between serum DHA levels and MMSE scores.Low serum DHA level is an independent risk factor for PSCI.The serum level of ω3-PUFAs is of high value in the auxiliary diagnosis and evaluation of PSCI.

关 键 词：ω3多不饱和脂肪酸 脑卒中后认知障碍 简明精神状态量表 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]