脑小血管病认知障碍患者脑电功率谱变化与中性粒细胞/淋巴细胞比值相关性及临床价值研究  

Relationship between electroencephalographic power spectrum changes and NLR in CSVCI patients and its clinical value

作　　者：郭晓敏[1] 魏爱芹 刘宗伟 袁维帅 朱娜[1] GUO Xiaomin;WEI Aiqin;LIU Zongwei;YUAN Weishuai;ZHU Na(Shaanxi Province People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院,陕西西安710068 [2]自然资源部第一海洋研究所,山东青岛266061

出　　处：《陕西医学杂志》2024年第3期361-367,共7页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2023-ZDLSF-20)。

摘　　要：目的:探索脑小血管病认知障碍(CSVCI)患者脑电功率谱变化与中性粒细胞/淋巴细胞比值(NLR)的相关性,并分析其临床价值。方法:收集脑小血管病(CSVD)患者61例,依据蒙特利尔认知评估量表(MoCA)评分,将其分为伴有认知障碍组(CSVCI组,29例)及无认知功能障碍组(CSVD组,32例),同期招募体检健康者20例为对照组(HC组)。对三组进行脑电图检查,比较全脑定量脑电图功率谱密度(PSD),并分析其与NLR的相关性。结果:CSVCI组年龄高于HC组,受教育年限低于CSVD组和HC组(均P<0.05)。CSVCI组和CSVD组高血压占比高于HC组(均P<0.05)。CSVCI组脑室旁及总脑白质Fazekas评分高于CSVD组和HC组,且CSVD组高于HC组(均P<0.05)。CSVCI组和CSVD组深部脑白质Fazekas评分高于HC组(均P<0.05)。CSVCI组δ、θ频段PSD值高于CSVD组,α频段PSD值低于CSVD组和HC组,CSVD组δ频段PSD值低于HC组(均P<0.05)。多因素Logistic回归表明α频段全脑PSD减低及受教育年限低为CSVCI发生的独立危险因素(均P<0.05)。CSVD患者α频段PSD值与MoCA评分呈正相关,δ频段PSD值与MoCA评分呈负相关,且脑室旁Fazekas评分、深部脑白质Fazekas评分及总脑白质Fazekas评分与MoCA评分呈负相关(均P<0.05)。NLR与θ频段全脑PSD呈正相关(P<0.05)。结论:CSVCI患者脑电快波活动减低而慢波活动增加。α频段全脑PSD值独立于Fazekas评分外影响CSVD患者认知障碍的发生,可能成为评估认知障碍严重程度、预测认知障碍发生的早期客观指标。NLR可能为导致脑电慢化的机制,有可能成为早期预测脑电慢化、认知障碍的客观指标。Objective:To explore the correlation between electroencephalographic power spectrum changes and neutrophil/lymphocyte ratio(NLR)in patients with cerebral small vessel disease cognitive impairment(CSVCI),and to analyze its clinical value.Methods:A total of 61 CSVD patients were collected and divided into CSVCI group(29 cases)and CSVD group(32 cases)according to MoCA score.Twenty healthy subjects were recruited as control group(HC group).EEG was performed in the three groups,and the whole brain quantitative EEG power spectral density(PSD)was compared between three groups,and its correlation with NLR was analyzed.Results:The CSVCI group was older than the HC group,and the years of education was lower than the CSVD group and the HC group(all P<0.05).The proportion of hypertension in the CSVCI and CSVD groups was higher than that in the HC group(all P<0.05).The Fazekas scores of periventricular and total white matter in the CSVCI group were higher than those in the CSVD group and the HC group,and those in the CSVD group were higher than those in the HC group(all P<0.05).The Fazekas scores of the deep white matter in the CSVCI and CSVD groups were higher than those in the HC group(all P<0.05).The PSD values in theδandθbands of the CSVCI group were higher than those of the CSVD group,while the PSD values in theαband were lower than those of the CSVD and HC groups,the PSD values in theδband in the CSVD group were lower than those in the HC group(all P<0.05).Multifactorial Logistic regression showed that the reduction of global PSD inαband and the low level of education were independent risk factors for CSVCI(all P<0.05).In CSVD patients,the PSD value inαband was positively correlated with MoCA score,the PSD value inδband was negatively correlated with MoCA score,and the Fazekas scores of periventricular,deep white matter and total white matter were negatively correlated with MoCA score(all P<0.05).NLR was positively correlated with the whole brain PSD inθband(P<0.05).Conclusion:The EEG fast wave activity is decre

关 键 词：脑小血管病认知障碍 中性粒细胞/淋巴细胞比值 蒙特利尔认知评估量表 脑电图 功率谱密度 相关性 

分 类 号：R749.1[医药卫生—神经病学与精神病学]