血清胆固醇水平与卒中后认知障碍相关性研究  

Serum cholesterol levels are associated with poststroke cognitive impairment

作　　者：黄峰敏 杨晓丽 吴丹红 Fengmin HUANG;Xiaoli YANG;Danhong WU(General Department of Gumei Community Health Service Center in Minhang District,Shanghai 201102,China;Center of Community-Based Health Research,Fudan University,Shanghai 200438,China;Department of Neurology,Shanghai Fifth People's Hospital affiliated to Fudan University,Shanghai 200240,China)

机构地区：[1]上海市闵行区古美社区卫生服务中心全科,上海201102 [2]复旦大学社区健康研究中心,上海200438 [3]复旦大学附属上海市第五人民医院神经内科,上海200240

出　　处：《阿尔茨海默病及相关病杂志》2023年第4期272-278,共7页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：复旦大学社区健康研究中心社区健康科研课题(2020SJ04)。

摘　　要：目的:探讨血清胆固醇水平及其动态变化与卒中后认知障碍(PSCI)之间的关系。方法:招募首次急性缺血性脑卒中患者。在卒中发病3~6个月后使用蒙特利尔认知量表(MoCA)评估患者的认知功能,分为PSCI组和无PSCI组,比较两组血清胆固醇基线和3~6个月随访时水平及其变化值。采用了Pearson相关分析和logistic回归分析探索血清胆固醇水平与PSCI的关系。结果:本研究纳入107例患者,其中PSCI组46例,无PSCI组61例。PSCI患者随访时血清总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平明显高于无PSCI组患者(3.74±1.04 vs 3.38±0.76,P=0.042;2.20±0.96 vs 1.87±0.67,P=0.039),且指标下降幅度小,但是无统计学意义(P>0.05)。PSCI组患者随访时血清TC水平(r=-0.332,P=0.024)及其变化值(r=-0.334,P=0.023)、LDL-C水平(r=-0.316,P=0.032)及其变化值(r=-0.332,P=0.024)均与延迟回忆呈负相关。单因素回归分析中显示卒中后3~6个月时的LDL-C水平(OR:1.687,95%CI:1.004-2.835,P=0.048)和TC水平(OR:1.609,95%CI:0.997-2.598,P=0.052)与PSCI有关,调整混杂因素后无统计学差异(P>0.05)。结论:在卒中发病3~6个月时,患者血清LDL-C及TC水平与PSCI之间存在着相关性,且与延迟回忆呈负相关,而血清胆固醇变化值与PSCI无相关性。Objective:To explore the correlation between serum cholesterol level and its dynamic changes and poststroke cognitive impairment(PSCI).Methods:Recruit patients with first acute ischemic stroke.After 3-6 months of stroke onset,patients'cognitive function was evaluated with the Montreal Cognitive Scale(MoCA),which was divided into PSCI group and non-PSCI group.The baseline and 3-6 months follow-up levels of serum cholesterol and their changes were compared between the two groups.Pearson correlation analysis and logistic regression analysis were used to explore the relationship between serum cholesterol level and PSCI.Results:This study included 107 patients,including 46 cases in PSCI group and 61 cases in non-PSCI group.The levels of serum total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)in patients with PSCI were significantly higher than those in patients without PSCI(3.74±1.04 vs 3.38±0.76,P=0.042;2.20±0.96 vs 1.87±0.67,P=0.039)and the indexes decreased slightly,but there was no statistical significance(P>0.05).In addition,the serum TC level(r=-0.332,P=0.024)and its changes(r=-0.334,P=0.023),LDL-C level(r=-0.316,P=0.032)and its changes(r=-0.332,P=0.024)in PSCI group were negatively correlated with delayed memory.Univariate regression analysis showed that the levels of LDL-C(OR:1.687,95%CI:1.004-2.835,P=0.048)and TC(OR:1.609,95%CI:0.997-2.598,P=0.052)at 3-6 months after stroke was associated with PSCI,with no statistically significant difference after adjusting for confounding factors(P>0.05).Conclusion:At 3-6 months after stroke onset,serum LDL-C and TC levels are correlated with PSCI,and negatively correlated with delayed memory.There was no correlation between the change of serum cholesterol and PSCI.

关 键 词：脑卒中 血清胆固醇 卒中后认知障碍 

分 类 号：R749.1[医药卫生—神经病学与精神病学]