摘要
目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)联合脑白质高信号(WMH)对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入CSVD患者240例,根据蒙特利尔认知评估量表(MoCA)将所有研究对象分为无认知障碍组(MoCA≥26分)120例和认知障碍组(MoCA<26分)120例。采用Fazekas量表对脑室旁脑白质高信号(PWMHs)和深部脑白质高信号(DWMHs)分别进行评分,两部分相加即为总分,通过分值对WMH严重程度进行分级。比较2组患者基线资料,血清Lp-PLA2、Hcy水平及WMH严重程度;Logistic回归分析CSVD患者认知障碍的影响因素;受试者工作特征(ROC)曲线评估血清Lp-PLA2、Hcy水平、WMH对CSVD患者认知障碍的预测价值。结果与无认知障碍组相比,认知障碍组年龄更大,血清Lp-PLA2、Hcy水平更高,WMH更重(P<0.05)。血清Lp-PLA2、Hcy、WMH均为CSVD患者发生认知障碍的影响因素(P<0.05)。ROC曲线分析结果显示血清Lp-PLA2、Hcy联合WMH预测CSVD患者认知障碍的曲线下面积为0.812,敏感度为81.7%,特异度为71.7%。结论CSVD认知障碍患者血清Lp-PLA2、Hcy水平更高,WMH更重,三者联合对CSVD患者认知障碍具有较高的预测价值。
Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)combined with white matter hyperintensities(WMH)for cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods A total of 240 patients with CSVD were selected.According to the Montreal Cognitive Assessment(MoCA)scale,all subjects were divided into the non-cognitive impairment group(MoCA≥26 points,120 cases)and the cognitive impairment group(MoCA<26 points,120 cases).Paraventricular white matter high signal(PWMHs)and deep white matter high signal(DWMHs)were scored by Fazekas scale.The sum of the two parts was the total score,and the severity of DWMHs was graded by the score.The basic information,serum Lp-PLA2,Hcy level and severity of WMH were compared between the two groups.Logistic regression was applied to analyze influencing factors of cognitive impairment in CSVD patients.The predictive value of serum level of Lp-PLA2 and Hcy and WMH for cognitive impairment in CSVD patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the non-cognitive impairment group,patients of the cognitive impairment group were older,had higher serum levels of Lp-PLA2 and Hcy,and had more severe of WMH(P<0.05).Results of Logistic regression analysis showed that serum Lp-PLA2,Hcy levels and severity of WMH were influencing factors for cognitive impairment of patients with CSVD(P<0.05).The results of ROC curve analysis showed that the area under the curve of serum Lp-PLA2,Hcy level combined with severity of WMH predicting cognitive impairment in patents with CSVD was 0.812,the sensitivity was 81.7%and the specificity was 71.7%(P<0.05).Conclusion Patients with cognitive impairment caused by CSVD have higher serum levels of Lp-PLA2 and Hcy,and more severe WMH.The combination of the three has a relatively high predictive value for cognitive impairment in patents with CSVD.
作者
焦爱菊
朱若兰
张春花
李文瑞
孙霞
赵玮婧
任宝龙
JIAO Aiju;ZHU Ruolan;ZHANG Chunhua;LI Wenrui;SUN Xia;ZHAO Weijing;REN Baolong(Department of Neurology,Gansu Wuwei Tumour Hospital(Gansu Province Wuwei Academy of Medical Sciences),Wuwei 733000,China;WardⅡDepartment of Neurology,Gansu Province Hospital)
出处
《天津医药》
2025年第8期846-850,共5页
Tianjin Medical Journal
基金
甘肃省重点研发项目(21YF5FH212)
武威市科技计划B类项目(WW23B02SF042)。
