MHR对急性腔隙性脑梗死患者认知功能的预测价值  

The predictive value of MHR on cognitive function in patients with acute lacunar cerebral infarction

作　　者：刘莉 朱静 李洪贺 张文雅 曹忠钰 齐立丹 LIU Li;ZHU Jing;LI Honghe;ZHANG Wenya;CAO Zhongyu;QI Lidan(Department of Neurology,964 Hospital,Changchun,Jilin,China,130000;Department of Intensive Care Medicine,964 Hospital,Changchun,Jilin,China,130000;The Second Outpatient Department,964 Hospital,Changchun,Jilin,China,130000;Medical Service Training Center,964 Hospital,Changchun,Jilin,China,130000;Department of Hematology and Oncology,964 Hospital,Changchun,Jilin,China,130000)

机构地区：[1]第九六四医院神经内科,吉林长春130000 [2]第九六四医院重症医学科,吉林长春130000 [3]第九六四医院第二门诊部,吉林长春130000 [4]第九六四医院卫勤训练中心,吉林长春130000 [5]第九六四医院血液肿瘤内科,吉林长春130000

出　　处：《分子诊断与治疗杂志》2025年第1期30-33,共4页Journal of Molecular Diagnostics and Therapy

基　　金：吉林省卫生健康科技能力提升项目(2023GW020)。

摘　　要：目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)对急性腔隙性脑梗死(ALCI)患者认知功能的预测价值。方法根据简易智能精神状态检查量表(MMSE)将2021年5月至2024年1月第九六四医院收治的153例ALCI患者分入认知功能正常组(MMSE≥27分,n=118)和认知功能障碍组(MMSE<27分,n=35)。检测两组单核细胞(MN)、高密度脂蛋白胆固醇(HDL⁃C)水平,并计算二者比值(MHR);采用受试者工作特性(ROC)曲线评估MHR对ALCI患者认知功能的预测价值;采用多因素Logistic逐步回归分析探讨ALCI患者认知功能的影响因素。结果认知功能障碍组MN、MHR高于认知功能正常组,HDL⁃C低于认知功能正常组,差异有统计学意义(P<0.05)。MN、HDL⁃C、MHR预测ALCI患者认知功能的曲线下面积(AUC)(95%CI)分别为0.775(0.723~0.937)、0.867(0.815~0.919)、0.905(0.853~0.956)。认知功能障碍组年龄≥60岁、高血压史、糖尿病史、病灶数量(多发)、有脑白质病变的患者占比均大于认知功能正常组,LDL⁃C、Hcy水平高于认知功能正常组,差异有统计学意义(P<0.05)。年龄≥60岁、有脑白质病变、Hcy升高、MHR增加是ALCI患者认知功能障碍的独立危险因素(P<0.05)。结论MHR增加与ALCI患者认知功能障碍有关,该标记物对ALCI患者认知功能障碍具有较高的预测价值。Objective To explore the predictive value of monocyte/high⁃density lipoprotein cholesterol ratio(MHR)for cognitive function in patients with acute lacunar cerebral infarction(ALCI).Methods 153 patients with ALCI were admitted to our hospital from May 2021 to January 2024.They were divided into two groups:a normal cognitive group(MMSE≥27 points,n=118)and a cognitive dysfunction group(MMSE<27 points,n=35)based on the simple Intelligent mental State Examination Scale(MMSE).The levels of MN and HDL⁃C were measured,and their ratio(MHR)was calculated.The predictive value of MN,HDL⁃C,and MHR in the cognitive function of ALCI patients was evaluated using ROC analysis.The influencing factors of cognitive function in ALCI patients were explored through Binary Logistic stepwise regression.Results The mean values of MN and MHR in the cognitive impairment group were higher than those in the normal cognitive function group,while HDL⁃C was lower than in the normal cognitive function group,showing statistically significant differences(P<0.05).The area under the curve(AUC)(95%CI)of MN,HDL⁃C and MHR for predicting cognitive function in patients with ALCI wase 0.775(0.723~0.937),0.867(0.815~0.919)and 0.905(0.853~0.956),respectively.Individuals aged≥60 years old,with a history of hypertension,history of diabetes,multiple lesions(multiple)and a higher proportion of leukoencephalopathy were more prevalent in the cognitive dysfunction group compared to the normal cognitive function group.The levels of LDL⁃C and Hcy were higher in the cognitive dysfunction group than in the normal cognitive function group(P<0.05).Age≥60 years,presence of white matter lesions,elevated Hcy levels,and increased MHR were identified as independent risk factors for cognitive impairment in ALCI patients(P<0.05).Conclusion The increase in MHR is associated with cognitive impairment in ALCI patients,and this marker has high predictive value for cognitive impairment in these patients.

关 键 词：单核细胞/高密度脂蛋白胆固醇比值 急性腔隙性脑梗死 认知功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]