血清白蛋白、尿素氮及Fazekas评分与轻中型缺血性脑卒中患者急性期认知功能的相关性研究  

Correlation between serum albumin,urea nitrogen and Fazekas scores and cognitive function in patients with mild and medium ischemic stroke

作　　者：桂英 李丽娟 李仙 刘婷 郭晓鹏 贾丹丹 马琳[1] Gui Ying;Li Lijuan;Li Xian;Liu Ting;Guo Xiaopeng;Jia Dandan;Ma Lin(Department of Neurology,The First Affiliated Hospital of Hainan Medical College,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院神经内科,海口570102

出　　处：《中国综合临床》2024年第3期161-168,共8页Clinical Medicine of China

基　　金：海南省自然科学基金-青年基金(821QN0987);海南省自然科学基金-高层次人才项目(821RC1121);海南省临床医学中心建设项目(2021)。

摘　　要：目的分析血清白蛋白、尿素氮及Fazekas评分与轻中型缺血性脑卒中患者急性期认知功能评分的相关性。方法选取海南医学院第一附属医院神经内科2021年6月至2023年4月连续收治的160例美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)≤7分的急性缺血性脑卒中患者临床资料进行横断面研究,依照蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分,分为认知正常组28例(MoCA≥26分)、轻-中度认知障碍组74例(MoCA 15~<26分)、重度认知障碍组58例(MoCA<15分)。收集患者人口学特征、血清学指标和影像学资料,对血清白蛋白、尿素氮及Fazekas评分等与MoCA总分、各认知域得分进行相关性分析。正态分布及方差齐的计量资料组间比较用单因素方差分析,两两比较采用LSD分析;偏态分布或方差不齐的计量资料组间进行Kruskal-WallisH检验,两两比较采用Bonferroni校正分析。计数资料组间进行卡方检验或者Fisher确切概率法。血清白蛋白、尿素氮及Fazekas评分等与MoCA总分及各认知域得分进行Spearman相关分析。采用多元有序Logistic回归,分析轻中型缺血性脑卒中患者急性期认知功能的独立危险因素。结果急性轻中型缺血性脑卒中患者认知障碍发生率为82.50%(132/160)。认知正常组、轻-中度认知障碍组、重度认知障碍组患者年龄[(56.71±7.35)、(60.32±10.20)、(66.40±11.88)岁]、性别[男/女:(23/5、58/16、33/25)]、高中以上受教育程度占比[25.0%(7/28)、16.2%(12/74)、6.9%(4/58)]、血红蛋白[(149.26±14.91)、(144.85±16.85)、(137.63±17.22)g/L]、白蛋白[39.5(37.0,41.2)、38.6(35.6,40.8)、37.4(34.5,39.8)g/L]、尿素氮[5.30(4.00,6.60)、4.81(4.00,6.32)、5.86(4.55,6.97)mmol/L]、汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)评分[5.0(2.0,10.0)、7.5(5.0,11.0)、10.0(6.0,14.3)分]、汉密尔顿抑郁量表(hamilton depression scale,HAMD)评分[5.5(3.0,12.5)、7.0(4.0,11Objective To investigate the correlation between serum albumin,urea nitrogen and Fazekas scores and cognitive function scores in patients with mild and medium ischemic stroke.Methods Clinical data of 160 patients with acute ischemic stroke with the National Institutes of Health Stroke Scale(NIHSS)≤7 scores admitted to the Department of Neurology of the First Affiliated Hospital of Hainan Medical College from June 2021 to April 2023 were selected for a cross-sectional study.According to the Montreal Cognitive Assessment(MoCA)score,they were divided into normal cognitive group(28 cases)(MoCA≥26 scores),mild to moderate cognitive impairment group(74 cases)(MoCA 15-<26 scores),and severe cognitive impairment group(58 cases)(MoCA<15 scores).Demographic characteristics,serological indicators and imaging data of patients were collected,and the correlation between serum albumin,urea nitrogen and Fazekas scores and the total score of MoCA and the scores of each cognitive domain was analyzed.One-way ANOVA was used for comparison between the normal distribution and homogeneous variance data sets,LSD analysis was used for pairwise comparison,Kruskal-Wallis H test was used between the skew distribution or heterogeneous variance data sets.Bonferroni correction analysis was used for pairwise comparison.Chi-square test or Fisher exact probability method was used after the comparison between the count data sets.Spearman Spearman correlation analysis was performed on serum albumin,urea nitrogen and Fazekas scores with MoCA scores and cognitive domain scores.Multivariate ordered Logistic regression was used to analyze the independent risk factors of cognitive function in acute stage of mild and medium ischemic stroke patients.Results The incidence of cognitive impairment in patients with acute mild and medium ischemic stroke was 82.50%(132/160).Comparison of age((56.71±7.35),(60.32±10.20),(66.40±11.88)years old),sex(male/female:(23/5,58/16,33/25)),the proportion of education level above high school(25.0%(7/28),16.2%(12/74),6

关 键 词：急性轻中型缺血性脑卒中 认知功能 白蛋白 尿素氮 Fazekas评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]