血红蛋白含量、单核细胞与高密度脂蛋白胆固醇比值与卒中后认知障碍的相关性研究  

The correlation between hemoglobin,monocyte to high density lipoprotein cholestero ratio and post-stroke cognitive impairment

作　　者：戴科 黄娟娟 陆艳[3] 朱明跃[2] DAI Ke;HUANG Juanjuan;LU Yan(Department of Rehabilitation Medicine,Liyang Branch of Jiangsu Prorincial People’s Hospital,Liyang 213300,China)

机构地区：[1]江苏省人民医院溧阳分院康复科,213300 [2]南京医科大学第二附属医院康复科 [3]南京医科大学第二附属医院药学部

出　　处：《临床神经病学杂志》2023年第6期420-424,共5页Journal of Clinical Neurology

基　　金：江苏省中医药科技发展项目面上项目(MS2022140)。

摘　　要：目的分析Hb含量、单核细胞与高密度脂蛋白胆固醇比值(MHR)与卒中后认知障碍(PSCI)的相关性,探讨Hb、MHR辅助诊断与评价PSCI的临床应用价值。方法收集2021年1月至2022年12月南京医科大学第二附属医院康复科住院的首次脑卒中患者的临床资料,采用MMSE评分将患者分为PSCI组和卒中后无认知功能障碍(PSNCI)组,分析两组患者血清相关指标的水平差异,寻找PSCI发生的危险因素。结果共纳入81例卒中患者,PSCI组43例,PSNCI组38例,两组患者性别、年龄、高血压病史、糖尿病病史、吸烟、饮酒史、白细胞计数、中性粒细胞计数、淋巴细胞计数、血小板计数、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等差异均无统计学意义。PSCI组患者的Hb含量明显低于PSNCI组、MHR明显高于PSNCI组(均P<0.05)。Spearman相关性分析显示,Hb与卒中患者的MMSE评分呈正相关性(rs=0.353,P<0.05),MHR与卒中患者的MMSE评分呈负相关性(rs=-0.325,P<0.05)。是否发生PSCI为因变量分析显示,较低的Hb含量、较高的MHR是发生PSCI的独立风险因素(OR=1.056,95%CI:1.025~1.088,P<0.05;OR=0.059,95%CI:0.006~0.577,P<0.05)。Hb预测卒中患者发生PSCI的ROC曲线下面积为0.76(95%CI:0.656~0.865);MHR预测卒中患者发生PSCI的ROC曲线下面积为0.62(95%CI:0.497~0.742)。结论Hb含量、MHR与PSCI有显著相关性,Hb含量降低、MHR升高均为PSCI发生的独立风险因素,Hb含量、MHR对PSCI预测诊断有一定的参考价值。Objective The correlation between Hb content,monocyte to high density lipoprotein cholesterol ratio(MHR)and post-stroke cognitive impairment(PSCI)was analyzed,and the application value of Hb and MHR in assisting diagnosis and evaluation of PSCI was discussed.Methods The clinical data of first-time stroke patients admitted to the Rehabilitation Department of the Second Affiliated Hospital of Nanjing Medical University from January 2021 to December 2022 were collected.The patients were divided into PSCI group and post-stroke no cognitive impairment(PSNCI)group by using MMSE scores.The differences in serum related indicators between the two groups were analyzed to find the risk factors of PSCI.Results There were a total of 81 stroke patients,including 43 in the PSCI group and 38 in the PSNCI group.There were no statistically significant differences in gender,age,history of hypertension,diabetes,smoking,drinking history,white blood cell count,neutrophil count,lymphocyte count,platelet count,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol between the two groups.The Hb content in PSCI group was significantly lower than that in PSNCI group,and the MHR was significantly higher than that in PSNCI group(P<0.05).Spearman correlation analysis showed that Hb was positively correlated with MMSE score of stroke patients(rs=0.353,P<0.05),and MHR was negatively correlated with MMSE score of stroke patients(rs=-0.325,P<0.05).According to whether PSCI occurred as the dependent variable,the analysis showed that lower Hb content and higher MHR were independent risk factors for PSCI(OR=1.056,95%CI:1.025-1.088,P<0.05;OR=0.059,95%CI:0.006-0.577,P<0.05).The area under ROC curve of Hb in predicting PSCI in stroke patients was 0.76(95%CI:0.656-0.865).The area under ROC curve of MHR for predicting PSCI in stroke patients was 0.62(95%CI:0.497-0.742).Conclusions Hb content and MHR are significantly correlated with PSCI.The decrease of Hb content and the increase of MHR are independen

关 键 词：卒中后认知障碍 Hb 单核细胞与高密度脂蛋白胆固醇比值 MMSE 

分 类 号：R749.1[医药卫生—神经病学与精神病学]