赵平;孔令胜;洪波;季晓宇;任孝林;韩学聃;徐玲;刘丽艳;

• 1:徐州医科大学附属连云港市东方医院

摘要(Abstract)：

目的探讨血清胱抑素C(CysC)与老年缺血性脑卒中后认知功能障碍(PSCI)的相关性,分析CysC对PSCI的预测价值。方法收集2017-06—2019-06连云港市东方医院神经内科病房老年(>65岁)缺血性脑卒中患者,入院时分别记录(性别、年龄、受教育年限、既往史、血压、血脂、肾功能等)一般资料,入院治疗14 d后分别检测血清CysC水平,评定美国国立卫生研究院卒中量表(NIHSS)评分、简易智能状态检查量表(MMSE)评分及蒙特利尔认知评估量表(MoCA)评分。治疗14 d后MMSE评分及MoCA评分筛查出PSCI患者90例为PSCI组,同时筛查出非认知功能障碍患者90例为非PSCI组。对2组患者入院时一般资料及入院治疗14 d后CysC水平、MMSE评分进行单因素分析,并对血清CysC的相关因素进行分析;从中选择有差异的变量为自变量,并进行多重共线性的诊断,排除可能有共线性问题的自变量,纳入Logistic回归模型进行PSCI患病风险的分析。绘制血清CysC预测老年PSCI的ROC曲线,判定CysC对PSCI的预测价值。结果单因素分析显示2组患者的糖尿病患病率、高血压患病率、收缩压、舒张压、HbA1C、NIHSS、CysC、MMSE评分及MoCA评分差异有统计学意义(P<0.001)。Pearson相关分析显示血清CysC水平与收缩压(r=0.233,P=0.002)呈正相关,与MMSE评分(r=-0.456,P<0.001)及MoCA评分(r=-0.403,P<0.001)均呈负相关。多因素Logistic回归分析显示高血压(OR=2.186,95%CI 1.129～4.230,P=0.020)和CysC(<0.88:OR=1,P<0.001;0.88～1.08:OR=3.852,95%CI 1.689～8.789,P=0.001;>1.08:OR=8.310,95%CI 3.674～18.797,P<0.001)是老年缺血性脑卒中后认知障碍的相关危险因素。ROC曲线下AUC:0.773,P<0.0001,95%CI 0.705～0.832,最佳诊断界值为0.91 mg/L(敏感度83.33%,特异性60.00%,Youden指数0.433)。结论血清CysC与老年缺血性PSCI的严重程度存在相关性,是其发生发展的相关危险因素,并有一定预测价值。

关键词(KeyWords)： 缺血性脑卒中;认知功能障碍;老年人;影响因素;胱抑素C;血清

Abstract:

Keywords:

基金项目(Foundation): 连云港市青年科技项目(编号:201729)

作者(Authors): 赵平;孔令胜;洪波;季晓宇;任孝林;韩学聃;徐玲;刘丽艳;

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