基于中国深圳老龄化相关疾病队列的血液常规检查参数与认知功能减退相关性研究  

Association between the alterations in the blood routine check parameters and cognitive decline in the Shenzhen ageing-related disorder cohort in China

作　　者：吴凯钰 许春燕 田小苹 邱国真 刘威 郭启雯 陈淳淳 刘建军 刘亢丁[1] 朱飞奇 Kaiyu WU;Chunyan XU;Xiaoping TIAN;Guozhen QIU;Wei LIU;Qiwen GUO;Chunchun CHEN;Jianjun LIU;Kangding LIU;Feiqi ZHU(Department of Neurology,The First Hospital of Jilin University,Changchun City,Jilin Province,130021,China;Cognitive Impairment Ward of Neurology Department,The third Hospital of Shenzhen University Medical College,Shenzhen City,Guangdong Province,518001,China;Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong province,518055,China)

机构地区：[1]吉林大学第一附属医院神经内科,长春吉林130021 [2]深圳市罗湖区人民医院神经内科老年性认知障碍病房,广东深圳518001 [3]深圳市疾病预防与控制中心,广东深圳518055

出　　处：《阿尔茨海默病及相关病杂志》2023年第4期301-306,共6页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：深圳市医疗卫生三名工程项目“瑞典卡罗琳斯卡医学院NVS系Bengt Winblad教授阿尔茨海默病团队”(SZSM201801014);深圳市科创委重点项目“AD前期及患者健康管理大数据构建及其预测预警模型研究”(JCYJ20200109143431341)资助。

摘　　要：目的:探讨血液常规参数与认知功能减退的关系。方法:本回顾性病例对照研究中,2017年~2018年从深圳市罗湖区51个社区卫生中心纳入8025名60岁以上老人。根据简易精神状态检查(MMSE)评分和教育程度,被分为认知功能筛查阳性组(n=385)和认知功能筛查阴性组(n=7640)。对收集到的血常规检测数据(包括白细胞、淋巴细胞计数、中性粒细胞计数、单粒细胞计数、单核细胞计数、淋巴细胞、中性粒细胞、单核细胞、红细胞计数、红细胞、血红蛋白、平均红细胞体积、平均红细胞、平均红细胞血红蛋白浓度、血细胞压积、血小板计数、MPV、PDW和RDW,包括红细胞分布宽度标准差和红细胞分布宽度系数变量)采用非参数检验、卡方检验和二元逻辑回归法进行分析。结果:与认知功能筛查阴性组相比,认知功能筛查阳性组的淋巴细胞-单核细胞比率(LMR)、红细胞压积(PCV)和血小板计数(PLT)显著降低(7.26[5.50,8.81]vs.40.5[37.7,43.1];216[190,258]vs.228[196,261],P<0.05),而单核细胞计数和平均红细胞血红蛋白浓度(MCHC)较高(0.31[0.25,0.38]vs.0.3[0.24,0.37];336[330,343]vs.335[328,342],P<0.05)。此外,MCHC[比值比(OR):1.011,95%CI:1.001–1.021,P=0.033]和PCV[OR:0.993,95%CI:0.987–0.999,P=0.033]与认知功能减退独立相关。结论:一些常规血液检查参数的改变,包括LMR、PCV和PLT降低,单核细胞计数和MCHC升高,可能与认知功能减退有关。Objective:We aimed to explore the relationship between routine blood parameters and cognitive function decline.Methods:In this retrospective case-control study,8025 people over 60 years of age were enrolled from 51 community health centers in Luohu District of Shenzhen City from 2017 to 2018.According to the mini-mental state examination(MMSE)score and educational level,participants were divided into a cognitive function screening positive group(n=385)and cognitive function screening negative group(n=7,640).Nonparametric test,chi-square test,and binary logistic regression were applied to analyze the data.Results:Compared to the normal cognitive function group,the lymphocyte-to-monocyte ratio(LMR),packed-cell volume(PCV),and platelet count(PLT)in the cognitive impairment group were significantly lower(7.26[5.50,8.81]vs.7.45[5.80,9.35];40.1[36.65,42.95]vs.40.5[37.7,43.1];216[190,258]vs.228[196,261],P<0.05,respectively),while the monocyte count and mean corpuscular hemoglobin concentration(MCHC)were higher(0.31[0.25,0.38]vs.0.3[0.24,0.37];336[330,343]vs.335[328,342],P<0.05,respectively).Additionally,MCHC[odds ratio(OR):1.011,95%confidence interval(CI):1.001–1.021,P=0.033]and PCV[OR:0.993,95%CI:0.987–0.999,P=0.033]were independently associated with cognitive function decline.Conclusion:The alterations in some routine blood check parameters,including reduced LMR,PCV,and PLT,and elevated monocyte count and MCHC,may be associated with cognitive function decline.

关 键 词：认知功能减退 血常规检查参数 淋巴细胞与单核细胞比值 红细胞压积 血小板计数 单核细胞计数 平均红细胞血红蛋白浓度 

分 类 号：R74[医药卫生—神经病学与精神病学]