血管衰老指标与老年缺血性脑小血管病患者发生血管性认知障碍及其严重程度的关系  

Relationship between Vascular Aging Indexes and the Occurrence and Severity of Vascular Cognitive Impairment in Elderly Patients with Ischemic Cerebral Small Vessel Disease

作　　者：崔啸宇 马琳颖 吴小坤 郑娇 左俊琴 刘斌 张晋霞 CUI Xiaoyu;MA Linying;WU Xiaokun;ZHENG Jiao;ZUO Junqin;LIU Bin;ZHANG Jinxia(Department of Neurology,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院神经内一科,河北省唐山市063000

出　　处：《实用心脑肺血管病杂志》2025年第6期65-69,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省医学科学研究课题计划项目(20231276)。

摘　　要：目的分析血管衰老(VA)指标与老年缺血性脑小血管病(CSVD)患者发生血管性认知障碍及其严重程度的关系。方法选取2023年11月—2024年10月华北理工大学附属医院神经内一科收治的老年缺血性CSVD患者224例为研究对象。收集患者的一般资料。根据血管性认知障碍评估结果,将发生血管性认知障碍的患者作为血管性认知障碍组(134例),未发生血管性认知障碍的患者作为非血管性认知障碍组(90例)。根据蒙特利尔认知评估量表(MoCA)评分将血管性认知障碍组患者进一步分为轻度亚组(85例)和中重度亚组(49例)。检测患者入院时VA指标,包括肱-踝脉搏波传导速度(baPWV)、踝肱指数(ABI)、心-踝血管指数(CAVI)。老年缺血性CSVD患者发生血管性认知障碍的影响因素分析采用多因素Logistic回归分析;采用ROC曲线分析VA指标对老年缺血性CSVD患者发生血管性认知障碍的预测价值;两变量间的相关性分析采用Pearson相关分析。结果血管性认知障碍组有糖尿病史者占比、有脑卒中史者占比、LDL-C、同型半胱氨酸(Hcy)高于非血管性认知障碍组(P<0.05)。血管性认知障碍组baPWV快于非血管性认知障碍组,ABI低于非血管性认知障碍组,CAVI高于非血管性认知障碍组(P<0.05)。多因素Logistic回归分析结果显示,糖尿病史、Hcy、baPWV、ABI、CAVI是老年缺血性CSVD患者发生血管性认知障碍的独立影响因素(P<0.05)。ROC曲线分析结果显示,baPWV、ABI、CAVI预测老年缺血性CSVD患者发生血管性认知障碍的AUC分别为0.888〔95%CI(0.841~0.935)〕、0.612〔95%CI(0.538~0.685)〕、0.836〔95%CI(0.783~0.888)〕,最佳截断值分别为1095 cm/s、1.03、9.4,灵敏度分别为0.888、0.343、0.649,特异度分别为0.844、0.900、0.867。中重度亚组baPWV快于轻度亚组,ABI低于轻度亚组,CAVI高于轻度亚组(P<0.05)。Pearson相关分析结果显示,血管性认知障碍组患者baPWV、CAVI与MoCA评分呈负相�Objective To analyze the relationship between vascular aging(VA)indexes and the occurrence and severity of vascular cognitive impairment in elderly patients with ischemic cerebral small vessel disease(CSVD).Methods A total of 224 elderly patients with ischemic CSVD admitted to Department of Neurology,North China University of Science and Technology Affiliated Hospital from November 2023 to October 2024 were selected as the study objects.General data of patients was collected.According to the results of vascular cognitive impairment assessment,patients with vascular cognitive impairment were classified as vascular cognitive impairment group(134 cases),and patients without vascular cognitive impairment were classified as non-vascular cognitive impairment group(90 cases).According to the Montreal Cognitive Assessment(MoCA)score,patients in vascular cognitive impairment group were further divided into mild subgroup(85 cases)and moderate to severe subgroup(49 cases).VA indexes at admission,including brachial ankle pulse wave velocity(baPWV),ankle-brachial index(ABI),and cardio-ankle vascular index(CAVI),were measured.Multivariate Logistic regression analysis was used to analyze the influencing factors of vascular cognitive impairment in elderly patients with ischemic CSVD.ROC curve was used to analyze the predictive value of VA indexes for vascular cognitive impairment in elderly patients with ischemic CSVD.Pearson correlation analysis was used to analyze the correlation between the two variables.Results The proportion of patients with diabetes history,the proportion of patients with stroke history,LDL-C and homocysteine(Hcy)in vascular cognitive impairment group were higher than those in non-vascular cognitive impairment group(P<0.05).The baPWV in vascular cognitive impairment group was faster than that in non-vascular cognitive impairment group,ABI was lower than that in non-vascular cognitive impairment group,CAVI was higher than that in non-vascular cognitive impairment group(P<0.05).Multivariate Logistic regressi

关 键 词：大脑小血管疾病 认知障碍 血管衰老 肱-踝脉搏波传导速度 踝肱指数 心-踝血管指数 

分 类 号：R743[医药卫生—神经病学与精神病学] R741[医药卫生—临床医学]