尿神经丝轻链、高密度脂蛋白及载脂蛋白A1在脑梗死患者认知功能障碍中的作用和预测价值  

Role and predictive value of urinary neurofilament light chain, high-density lipoprotein, and apolipoprotein A_(1) in cognitive dysfunction in patients with cerebral infarction

作　　者：马莉 陈阳 杜宇平 万琦 许岩 MA Li;CHEN Yang;DU Yuping;WAN Qi;XU Yan(Department of Neurology,No.904 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Jiangsu Province,Wuxi214044,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇四医院神经内科,江苏无锡214044

出　　处：《中国医药导报》2024年第11期66-69,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20191500);江苏省无锡市卫生健康委科研项目(Z202217)。

摘　　要：目的探讨脑梗死患者的尿神经丝轻链(uNfL)、高密度脂蛋白(HDL)、载脂蛋白A_(1)(ApoA_(1))在脑梗死患者认知功能障碍中的作用和预测价值。方法收集中国人民解放军联勤保障部队第九〇四医院2021年1月至2023年1月收治的89例脑梗死患者的基本资料,根据简易精神状态检查量表(MMSE)不同,将患者分为认知功能正常组(52例)和认知功能障碍组(37例)。记录并比较两组uNfL、外周血HDL和ApoA_(1),并采用logistic回归模型将差异有统计学意义的指标纳入影响因素分析,采用受试者操作特征曲线进行预测价值分析。结果认知功能障碍组uNfL高于认知功能正常组,HDL和ApoA_(1)低于认知功能正常组(P<0.05)。uNfL、HDL和ApoA_(1)是缺血性脑梗死患者认知功能障碍的独立影响因素(P<0.05)。uNfL的灵敏度、特异度高于HDL和ApoA_(1);uNfL的曲线下面积大于HDL和ApoA_(1)(P<0.05)。结论uNfL、HDL、ApoA_(1)均可作为缺血性脑梗死患者认知功能障碍的重要预测指标,尤其是uNfL,其在早期识别和预防缺血性脑梗死患者认知功能障碍中具有重要的临床价值。Objective To investigate the role and predictive value of urinary neurofilament light chain(uNfL),high-density lipoprotein(HDL),and apolipoprotein A_(1)(ApoA_(1))in cognitive dysfunction in patients with cerebral infarction.Methods A total of 89 patients with cerebral infarction admitted to NO.904 Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation Army from January 2021 to January 2023 were collected.According to the simple mental state examination scale(MMSE),the patients were divided into the normal cognitive function group(52 cases)and the cognitive dysfunction group(37 cases).The uNfL,peripheral blood HDL,and ApoA_(1)were recorded and compared between the two groups,logistic regression model was used to incorporate statistically significant indicators into the analysis of influencing factors,and the predictive value was analyzed by subject working characteristic curve.Results uNfL in cognitive dysfunction group was higher than that in normal cognitive function group,HDL and ApoA_(1)were lower than those in normal cognitive function group(P<0.05).uNfL,HDL,and ApoA_(1)were independent influencing factors of cognitive dysfunction in patients with ischemic cerebral infarction(P<0.05).The sensitivity and specificity of uNfL were higher than those of HDL and ApoA_(1).The area under curve of uNfL was larger than that of HDL and ApoA_(1)(P<0.05).Conclusion uNfL,HDL,and ApoA_(1)can be served as important predictive indicators for cognitive dysfunction in patients with cerebral infarction,especially uNfL,which has important clinical value in early identification and prevention of cognitive dysfunction in patients with cerebral infarction.

关 键 词：尿神经丝轻链 脑梗死后认知功能障碍 高密度脂蛋白 载脂蛋白A_(1) 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]