脑梗死患者认知障碍与脑白质病变相关性分析  

Correlation Between Cognitive Impairment and White Matter Lesions in Patients with Cerebral Infarction

作　　者：曹栋[1] 张文召[1] 梁斐[1] CAO Dong;ZHANG Wenzhao;LIANG Fei(Department of Neurology,the First People’s Hospital of Nanyang,Nanyan 473000,China)

机构地区：[1]南阳市第一人民医院神经内三科,河南南阳473000

出　　处：《河南医学研究》2024年第2期272-277,共6页Henan Medical Research

摘　　要：目的探讨脑梗死(CI)患者认知障碍与脑白质病变(WML)的相关性,基于多因素logistic回归分析认知障碍并发WML的危险因素。方法选取2020年8月至2022年10月医院收治的134例CI患者为研究对象,依据是否发生认知障碍分为发生组(56例)、未发生组(78例)。比较两组一般资料,分析认知障碍与年龄相关性脑白质改变评分(ARWMC)相关性。发生组患者依据是否发生WML病变分为非病变者36例、病变者20例,并分析WML病变者、非病变者血清学指标[视黄醇结合蛋白(RBP)、半乳糖凝集素-3(Galectin-3)、白细胞介素-33(IL-33)]水平。多因素logistic回归分析认知障碍并发WML的危险因素。评价危险因素联合预测认知障碍并发WML的预测价值。结果CI患者认知障碍与入院时ARWMC评分存在线性关系(P=0.005),且认知障碍与入院时ARWMC评分呈正相关(r=0.485,P<0.001)。病变者年龄、入院时NIHSS评分、重度颈动脉狭窄占比、多梗死灶占比高于非病变者,血清RBP、Galectin-3、IL-33水平高于非病变者(P<0.05)。高龄、入院时NIHSS评分增加、颈动脉狭窄程度加重、多梗死灶及血清RBP、Galectin-3、IL-33水平升高均为认知障碍并发WML的危险因素(P<0.05)。危险因素联合预测认知障碍并发WML的曲线下面积大于血清RBP、Galectin-3、IL-33单独预测(P<0.05)。结论CI患者认知障碍与WML呈正相关,年龄增长、入院时NIHSS评分增加、颈动脉狭窄程度增加、多梗死灶及血清RBP、Galectin-3、IL-33水平升高是影响认知障碍并发WML的危险因素,基于危险因素建立logistic回归预测模型,该模型对认知障碍并发WML具有一定预测价值。Objective To explore the correlation between cognitive impairment and white matter lesions(WML)in patients with cerebral infarction(CI),and to analyze the risk factors of cognitive impairment complicated with WML based on multivariate logistic regression.Methods A total of 134 patients with CI admitted to our hospital from August 2020 to October 2022 were selected as research objects.According to whether cognitive impairment occurred,they were divided into the developing group(56 cases)and the non-developing group(78 cases).Baseline data of the two groups were compared to analyze the correlation between cognitive impairment and age-related white matter change score(ARWMC).According to the occurrence of WML lesions,patients in the occurrence group were divided into 36 patients with non-lesions and 20 patients with lesions.Serological indexes[retinol-binding protein(RBP),Galectin-3,interleukin-33(IL-33)]in patients with lesions and non-lesions were analyzed.Multivariate logistic regression analysis of the risk factors of cognitive impairment complicated with WML.To evaluate the predictive value of risk factors in predicting cognitive impairment complicated with WML.Results There was a linear relationship between cognitive impairment and ARWMC score on admission(P=0.005),and a positive correlation between cognitive impairment and ARWMC score on admission(r=0.485,P<0.001).The age,NIHSS score at admission,the proportion of severe carotid artery stenosis and the proportion of multiple infarcts were higher in patients with pathological changes than those without pathological changes,and the serum levels of RBP,Galectin-3 and IL-33 were higher than those without pathological changes(P<0.05).Advanced age,increased NIHSS score at admission,aggravated carotid artery stenosis,multiple infarcts and increased serum RBP,Galectin-3,IL-33 levels were all risk factors for cognitive impairment complicated with WML(P<0.05).The area under curve of cognitive impairment combined with WML was higher than that of serum RBP,Galectin-3,IL-

关 键 词：脑梗死 认知障碍 脑白质病变 关系 

分 类 号：R743.3[医药卫生—神经病学与精神病学]