摘要
目的研究低密度脂蛋白胆固醇(LDL-C)对脑小血管病(CSVD)患者轻度认知功能障碍(MCI)的诊断研究价值。方法回顾性收集该院神经内科2019年10月至2021年10月符合诊断标准的CSVD患者360例。依据MoCA评分标准,分为血管性轻度认知障碍(VMCI)组180例(MoCA评分18~<26分)与非VMCI组180例(MoCA评分≥26分)。比较2组患者一般人口学资料及脑血管病危险因素,采用二元logistic回归分析识别潜在的危险因素,并利用受试者工作特征(ROC)曲线判断LDL-C对CSVD患者MCI的诊断阈值。结果在一般人口学资料比较方面,VMCI组与非VMCI组性别、BMI差异无统计学意义(P>0.05),但与非VMCI组比较,VMCI组的年龄更大,教育程度更低(P<0.05)。在脑血管病危险因素比较方面,VMCI组既往有脂蛋白代谢综合征比例更高,在医院治疗期间,收缩压(SBP)、LDL-C、肌钙蛋白I(TnI)水平更高,空腹血糖(Glu)水平更低,差异有统计学意义(P<0.05)。脂代谢综合征、SBP、Glu、LDL-C、TnI预测VMCI的灵敏度和特异度分别为0.328、0.761、0.994、0.656、0.489和0.794、0.428、0.005、0.611、0.728。将上述差异有统计学意义的因素代入二元logistics回归分析显示,年龄、受教育年限、LDL-C、TnI均是VMCI的独立危险因素,其中年龄、LDL-C、TnI水平高,发生VMCI的风险增加,受教育年限高,发生VMCI的风险降低。ROC曲线显示多变量联合预测VMCI模型AUC为0.738(0.687~0.789),灵敏度为0.750,特异度为0.633。结论LDL-C水平对预测CSVD患者发生VMCI具有较高的诊断价值。
Objective To investigate the diagnostic value of low-density lipoprotein cholesterol(LDL-C)for mild cognitive impairment(MCI)in patients with cerebral small vessel disease.Methods A total of 360 patients with cerebralsmall vascular disease(CSVD)who met the diagnostic criteria in the department of Neurology of our hospital from October 2019 to October 2021 were retrospectively collected.According to the MoCA scoring criteria,all patients were divided into the vascular mild cognitive impairment(VMCI)group(MoCA score between 18 and 26 points)and the non-VMCI group(MoCA score reached or exceeded 26 points),with 180 cases in each group.Compare the general demographic data and risk factors for cerebrovascular disease between two groups of patients,use binary logistic regression analysis to identify potential risk factors,and use ROC receiver operating curve to determine the diagnostic threshold of LDL-C for mild cognitive impairment in patients with cerebral small vessel disease.Results In terms of general demographic data,there was no significant difference in gender and BMI between the VMCI group and the non-VMCI group(P>0.05),but compared with the non-VMCI group,the VMCI group was older and the education level was lower(P<0.05).In terms of cerebral vascular disease risk factors,VMCI group had a higher proportion of previous lipoprotein metabolic syndrome,and during hospital treatment,systolic blood pressure(SBP),LDL-C and troponin I(TnI)levels were higher,fasting blood glucose(Glu)levels were lower,with statistical significance(P<0.05).The sensitivity and specificity of lipid metabolic syndrome,SBP,fasting glucose Glu,LDL-C and TnI to predict VMCI were 0.328,0.761,0.994,0.656,0.489 and 0.794,0.428,0.005,0.611 and 0.728,respectively.The above statistically significant factors were replaced by binary logistics regression analysis,which showed that age,years of education,LDL-C and TnI were all independent risk factors for VMCI.Among them,higher levels of age,LDL-C and TnI would increase the risk of mild cognitive impairment,and higher years of education would increase the risk of mild cognitive impairment.Reduced risk of developing mild cognitive impairment.The ROC receiver operating curve showed that the AUC of the multivariable combined prediction model of MCI was 0.738(0.687-0.789),the sensitivity was 0.750 and the specificity was 0.633.Conclusion LDL-C level has high diagnostic value in predicting mild cognitive impairment in patients with cerebral small vascular disease.
作者
陈莉
伍绍强
汪顺利
张巧玉
钟华
CHEN Li;WU Shaoqiang;WANG Shunli;ZHANG Qiaoyu;ZHONG Hua(Department of Neurology,Nanchuan Hospital Affiliated to Chongqing Medical University,Chongqing 408400,China)
出处
《现代医药卫生》
2025年第7期1569-1574,共6页
Journal of Modern Medicine & Health
基金
重庆市卫生健康委员会科卫联合项目(2019MSXM108)
重庆医科大学教育教学改革研究项目(JY20230341)
重庆市公共卫生重点专科(学科)建设经费资助项目。
关键词
低密度脂蛋白胆固醇
脑小血管病
血管认知障碍
诊断
Low-density lipoprotein cholesterol
Cerebral small vessel disease
Vasular cognitive impairment
Diagnosis
