临床神经病学杂志
臨床神經病學雜誌
림상신경병학잡지
JOURNAL OF CLINICAL NEUROLOGY
2014年
3期
199-202
,共4页
安晓雷%李传玲%郭靖%李晓宾
安曉雷%李傳玲%郭靖%李曉賓
안효뢰%리전령%곽정%리효빈
小血管病性认知功能障碍%危险因素%超敏C反应蛋白
小血管病性認知功能障礙%危險因素%超敏C反應蛋白
소혈관병성인지공능장애%위험인소%초민C반응단백
vascular cognitive impairment due to small vessel disease%risk factors%high-sensitivity C-reactive protein
目的：研究小血管病性认知功能障碍（ VCI-SVD ）的影响因素及其与血浆超敏C反应蛋白（ hs-CRP）水平的相关性。方法给256例SVD患者进行蒙特利尔认知评估（ MoCA）量表评分，以及临床资料收集和血糖化血红蛋白、血脂、hs-CRP水平检测。分为VCI-SVD组（ MoCA量表评分≤26分）和无VCI-SVD组（ MoCA量表评分＞26分），对结果进行比较分析。结果 VCI-SVD组患者135例，无VCI-SVD组患者121例。 VCl-SVD组的血浆hs-CRP水平显著高于无VCI-SVD组（ P＜0.01），血糖化血红蛋白水平、收缩压，有房颤、吸烟、饮酒的比率显著高于无VCI-SVD组，受教育年限显著低于无VCI-SVD组（P＜0.05～0．01）。多因素Logistic回归分析显示，在校正了年龄、收缩压、教育年限、房颤、吸烟、饮酒因素后，糖化血红蛋白、高hs-CRP血症是VCI-SVD的独立危险因素（OR＝1．447，95％CI：1．25～5．54，OR＝1．587，95％CI：1．87～5．67，均P＜0.05）。相关分析显示，血浆hs-CRP水平与MoCA量表总分及视空间与执行能力、语言、延迟回忆各亚项评分呈负相关（r＝-0.621～-0．430，均P＜0.05）；与命名、抽象力、定向力和注意力亚项评分无相关性。结论糖尿病、高血压、房颤和吸烟、饮酒、受教育年限低及高hs-CRP血症是VCI-SVD的影响因素；而糖尿病、高hs-CRP血症是VCI-SVD的独立危险因素。
目的：研究小血管病性認知功能障礙（ VCI-SVD ）的影響因素及其與血漿超敏C反應蛋白（ hs-CRP）水平的相關性。方法給256例SVD患者進行矇特利爾認知評估（ MoCA）量錶評分，以及臨床資料收集和血糖化血紅蛋白、血脂、hs-CRP水平檢測。分為VCI-SVD組（ MoCA量錶評分≤26分）和無VCI-SVD組（ MoCA量錶評分＞26分），對結果進行比較分析。結果 VCI-SVD組患者135例，無VCI-SVD組患者121例。 VCl-SVD組的血漿hs-CRP水平顯著高于無VCI-SVD組（ P＜0.01），血糖化血紅蛋白水平、收縮壓，有房顫、吸煙、飲酒的比率顯著高于無VCI-SVD組，受教育年限顯著低于無VCI-SVD組（P＜0.05～0．01）。多因素Logistic迴歸分析顯示，在校正瞭年齡、收縮壓、教育年限、房顫、吸煙、飲酒因素後，糖化血紅蛋白、高hs-CRP血癥是VCI-SVD的獨立危險因素（OR＝1．447，95％CI：1．25～5．54，OR＝1．587，95％CI：1．87～5．67，均P＜0.05）。相關分析顯示，血漿hs-CRP水平與MoCA量錶總分及視空間與執行能力、語言、延遲迴憶各亞項評分呈負相關（r＝-0.621～-0．430，均P＜0.05）；與命名、抽象力、定嚮力和註意力亞項評分無相關性。結論糖尿病、高血壓、房顫和吸煙、飲酒、受教育年限低及高hs-CRP血癥是VCI-SVD的影響因素；而糖尿病、高hs-CRP血癥是VCI-SVD的獨立危險因素。
목적：연구소혈관병성인지공능장애（ VCI-SVD ）적영향인소급기여혈장초민C반응단백（ hs-CRP）수평적상관성。방법급256례SVD환자진행몽특리이인지평고（ MoCA）량표평분，이급림상자료수집화혈당화혈홍단백、혈지、hs-CRP수평검측。분위VCI-SVD조（ MoCA량표평분≤26분）화무VCI-SVD조（ MoCA량표평분＞26분），대결과진행비교분석。결과 VCI-SVD조환자135례，무VCI-SVD조환자121례。 VCl-SVD조적혈장hs-CRP수평현저고우무VCI-SVD조（ P＜0.01），혈당화혈홍단백수평、수축압，유방전、흡연、음주적비솔현저고우무VCI-SVD조，수교육년한현저저우무VCI-SVD조（P＜0.05～0．01）。다인소Logistic회귀분석현시，재교정료년령、수축압、교육년한、방전、흡연、음주인소후，당화혈홍단백、고hs-CRP혈증시VCI-SVD적독립위험인소（OR＝1．447，95％CI：1．25～5．54，OR＝1．587，95％CI：1．87～5．67，균P＜0.05）。상관분석현시，혈장hs-CRP수평여MoCA량표총분급시공간여집행능력、어언、연지회억각아항평분정부상관（r＝-0.621～-0．430，균P＜0.05）；여명명、추상력、정향력화주의력아항평분무상관성。결론당뇨병、고혈압、방전화흡연、음주、수교육년한저급고hs-CRP혈증시VCI-SVD적영향인소；이당뇨병、고hs-CRP혈증시VCI-SVD적독립위험인소。
Objective To investigate the influential factors of vascular cognitive impairment due to small vessel disease(VCI-SVD) and its correlation with serum high-sensitivity C-reactive protein ( hs-CRP).Methods Totally 256 patients with cerebral SVD were scored by Montreal Cognitive Assessment ( MoCA ) table and the level of glycosylated hemoglobin ,blood lipid and hs-CRP were measured respectively .They were divided into VCI-SVD group (MoCA≤26) and no VCI-SVD group(MoCA>26) , and the results were compared and analyzed .Results One hundred and thirty-five patients were classfied as VCI-SVD group, 121 patients were classfied as no VCI-SVD group. The serum levels of hs-CRP were higher significantly in VCI-SVD group compared with no VCI-SVD group ( P<0.01).Glycosylated hemoglobin levels , systolic blood pressure, atrial fibrillation, smoking, alcohol consumption were significantly higher than those in no VCI-SVD group, while years of education were significantly lower than that that in no VCI-SVD group(P<0.05~0.01).Multivariate logistic regression analysis showed , after controlling for correlation confounding risk factors , glycosylated hemoglobin levels and high serum hs-CRP were independent risk factors for VCI-SVD( OR=1.447,95%CI:1.25 -5.54,OR=1.587,95%CI:1.87 -5.67,all P<0.05).The correlation analysis showed that serum hs-CRP levels were negatively correlated with MoCA total score and visual-spatial and executive function,language,and short-term memory impairment(r=-0.621--0.430,all P<0.05), and had no correlation with name , abstract, orientation and attention items score .Conclusions Diabetes, hypertension, atrial fibrillation and smoking , drinking, years of education and the level of hs-CRP are the affecting factors of VCI-SVD, and diabetes and high serum hs-CRP are independent risk factors for VCI-SVD.
