广东医学
廣東醫學
엄동의학
GUNAGDONG MEDICAL JOURNAL
2015年
11期
1678-1680,1681
,共4页
急性脑梗死%血同型半胱氨酸%认知功能障碍
急性腦梗死%血同型半胱氨痠%認知功能障礙
급성뇌경사%혈동형반광안산%인지공능장애
acute cerebral infarction%blood homocysteine%cognitive impairment
目的：探讨血同型半胱氨酸（ Hcy）水平对急性脑梗死后认知功能障碍的影响。方法400例连续纳入的急性脑梗死患者根据蒙特利尔认知评估量表（ MoCA）评估结果分为无认知障碍组及认知障碍组，依据两组患者认知功能损害的潜在危险因素进行单因素分析，将有统计学意义的指标作为自变量，以MoCA评分为因变量进行多元线性回归分析，并依据血Hcy水平、年龄等进一步分层进行脑梗死后认知功能障碍的相对危险度及相关性评价。结果血Hcy是急性脑梗死后认知功能障碍的独立影响因素，存在高Hcy血症的患者比无高Hcy血症患者发生脑梗死后认知功能障碍的相对危险度是1.33，95％CI 1.018～1.733；年龄＞65岁的患者MoCA评分与血Hcy水平呈轻度负相关（ r＝－0.426，P＝0.048）；年龄≤65岁患者MoCA评分与血Hcy水平呈中度负相关（ r＝－0.518，P＝0.000）。结论血Hcy是急性脑梗死后认知功能障碍的独立影响因素，高Hcy血症时脑梗死后认知功能障碍的风险增高，中青年脑梗死患者血Hcy与认知功能水平得相关性高于老年患者。
目的：探討血同型半胱氨痠（ Hcy）水平對急性腦梗死後認知功能障礙的影響。方法400例連續納入的急性腦梗死患者根據矇特利爾認知評估量錶（ MoCA）評估結果分為無認知障礙組及認知障礙組，依據兩組患者認知功能損害的潛在危險因素進行單因素分析，將有統計學意義的指標作為自變量，以MoCA評分為因變量進行多元線性迴歸分析，併依據血Hcy水平、年齡等進一步分層進行腦梗死後認知功能障礙的相對危險度及相關性評價。結果血Hcy是急性腦梗死後認知功能障礙的獨立影響因素，存在高Hcy血癥的患者比無高Hcy血癥患者髮生腦梗死後認知功能障礙的相對危險度是1.33，95％CI 1.018～1.733；年齡＞65歲的患者MoCA評分與血Hcy水平呈輕度負相關（ r＝－0.426，P＝0.048）；年齡≤65歲患者MoCA評分與血Hcy水平呈中度負相關（ r＝－0.518，P＝0.000）。結論血Hcy是急性腦梗死後認知功能障礙的獨立影響因素，高Hcy血癥時腦梗死後認知功能障礙的風險增高，中青年腦梗死患者血Hcy與認知功能水平得相關性高于老年患者。
목적：탐토혈동형반광안산（ Hcy）수평대급성뇌경사후인지공능장애적영향。방법400례련속납입적급성뇌경사환자근거몽특리이인지평고량표（ MoCA）평고결과분위무인지장애조급인지장애조，의거량조환자인지공능손해적잠재위험인소진행단인소분석，장유통계학의의적지표작위자변량，이MoCA평분위인변량진행다원선성회귀분석，병의거혈Hcy수평、년령등진일보분층진행뇌경사후인지공능장애적상대위험도급상관성평개。결과혈Hcy시급성뇌경사후인지공능장애적독립영향인소，존재고Hcy혈증적환자비무고Hcy혈증환자발생뇌경사후인지공능장애적상대위험도시1.33，95％CI 1.018～1.733；년령＞65세적환자MoCA평분여혈Hcy수평정경도부상관（ r＝－0.426，P＝0.048）；년령≤65세환자MoCA평분여혈Hcy수평정중도부상관（ r＝－0.518，P＝0.000）。결론혈Hcy시급성뇌경사후인지공능장애적독립영향인소，고Hcy혈증시뇌경사후인지공능장애적풍험증고，중청년뇌경사환자혈Hcy여인지공능수평득상관성고우노년환자。
Objective To investigate the correlation between the blood homocysteine ( Hcy) and cognitive im-pairment after acute cerebral infarction by prospective study .Methods A total of 400 consecutive patients of acute cere-bral infarction were enrolled and divided into no cognitive impairment group and cognitive impairment group according to Montreal cognitive assessment ( MoCA) .Univariate analyses were conducted on the potential risk factors of cognitive im-pairment, including age, sex, smoking, alcohol, hypertension, diabetes, dyslipidemia, level of education, infarction in key parts, atrial fibrillation, serum uric acid and blood Hcy , between the two groups .The statistically significant indica-tors in univariate analyses were used as independent variables and the score of MoCA was used as the dependent variable for conduction of multiple linear regression analysis .The assessment of relative risks and correlation analysis in cognitive impairment after cerebral infarction were conducted according to level of blood Hcy and age .Results Blood Hcy was in-dependent risk factors of cognitive impairment after acute cerebral infarction according to univariate and multiple linear re -gression analyses (RR=1.33.95%CI 1.018-1.733).Mild negative correlation was discovered between blood Hcy and the score of MoCA in the patients older than 65 years (r=-0.426, P=0.048), as moderate negative correlation in the patient younger than 65 years old (r=-0.518, P=0.000).Conclusion Blood Hcy is independent risk factor of cogni-tive impairment after acute cerebral infarction .The risk of cognitive impairment after acute cerebral infarction is increased in patients with high blood Hcy .The correlation between cognitive impairment after acute cerebral infarction and blood Hcy is more prominent in young patients .
