吴纪霞;庄雷;刘洁一;张爱娣;王建伟;王兆平;

• 1:蚌埠市第一人民医院

摘要(Abstract)：

目的探讨血浆生化指标与血管认知障碍的相关性及预测指标。方法蚌埠市第一人民医院选取2013-12—2016-12 490例缺血卒中患者,3个月无复发,随诊3a,观测血浆生化指标与血管性认知障碍的相关性,患者使用《精神障碍诊断与统计手册IV》(DSMIV)标准,132例诊断为血管认知障碍(vascular cognitive impairment,VCI),采用简易精神状态量表(MMSE)对认知障碍程度进行评估,358例为非血管认知障碍患者,所有患者应用美国国立卫生院神经功能缺损评分(National Institute of Health Stroke Scale,NIHSS)对神经功能进行临床评估,日常生活活动能力量表(ADL)对日常生活能力进行评估,所有患者入院后行血浆生化指标检测、血常规、凝血6项、头CT、MRI影像检查。结果在人口特征因素分析中,在缺血性卒中患者血管认知障碍与认知正常组之间,年龄、吸烟、饮酒、高血压差异有统计学意义,在血浆生化指标分析中,高同型半胱氨酸、低密度脂蛋白在血管认知障碍与认知正常组之间差异有统计学意义;有意义指标用Logistic二分类回归分析血浆生化指标对血管认知障碍影响分析,年龄(OR0.43,95%CI为0.25⁰.726)、吸烟(OR0.63,95%CI为0.140.726)、吸烟(OR0.63,95%CI为0.14⁰.289)、饮酒(OR5.567,95%CI为1.1280.289)、饮酒(OR5.567,95%CI为1.128²5.43)、高血压(SBP≥160 mmHg)(OR12.17,95%CI为3.3325.43)、高血压(SBP≥160 mmHg)(OR12.17,95%CI为3.33⁴4.36)、同型半胱氨酸(OR1.025,95%CI为0.9944.36)、同型半胱氨酸(OR1.025,95%CI为0.99¹.052),低密度脂蛋白(OR0.873,95%CI为0.61.052),低密度脂蛋白(OR0.873,95%CI为0.6¹.271),余指标差异无统计学意义。结论高同型半胱氨酸血症和高密度脂蛋白血症对血管认知障碍有显著影响,可以作为独立危险因素,二者联合可以作为血管认知障碍的早期预测指标。

关键词(KeyWords)： 生化指标;同型半胱氨酸血症;缺血性卒中;预测指标;血管认知障碍

Abstract:

Keywords:

基金项目(Foundation): 蚌埠市科技局卫生项目(编号:20160313)

作者(Authors): 吴纪霞;庄雷;刘洁一;张爱娣;王建伟;王兆平;

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