摘要
目的探讨振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)、血清同型半胱氨酸(homocysteine,Hcy)对血管性认知障碍(vascular cognitive impairment,VCI)患者病情的评估价值。方法回顾性选取2023年6月至2024年12月秦皇岛市第一医院接诊的150例VCI患者,根据入院时蒙特利尔认知量表(Montreal cognitive assessment,MoCA)评分,将患者分为轻中度组(n=123)、重度组(n=27)。对所有患者进行aEEG监测,比较两组aEEG评分与血清Hcy水平,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析aEEG评分与Hcy水平对VCI病情的评估价值,并采用多因素Logistic回归分析VCI患者病情重度的影响因素。结果150例患者中,轻度病情78例、中度病情45例、重度病情有27例。重度组aEEG评分低于轻中度组,血清Hcy水平高于轻中度组(P<0.05)。aEEG评分、Hcy及二者联合预测VCI重度病情的曲线下面积(95%CI)分别为0.870(0.814~0.926)、0.806(0.698~0.913)、0.915(0.780~0.968)。重度组合并脑卒中史、糖尿病史、多重用药及吸烟史的比例,以及总胆固醇(total cholesterol,TC)、甘油三酯(triacylglycerol,TG)、C反应蛋白(C-reactive protein,CRP)水平均高于轻中度组(P<0.05)。aEEG评分降低、Hcy水平升高、多重用药、合并糖尿病是VCI患者病情重度的独立影响因素(P<0.05)。结论aEEG评分降低、Hcy水平升高与VCI患者病情严重程度密切相关,二者可作为评估VCI患者病情严重程度的敏感标志物。
Objective To investigate the evaluation value of amplitude-integrated electroencephalogram(aEEG)and serum homocysteine(Hcy)on the disease conditions of patients with vascular cognitive impairment(VCI).Methods A total of 150 patients with VCI admitted to First Hospital of Qinhuangdao from June 2023 to December 2024 were retrospectively selected.According to Montreal Cognitive Assessment(MoCA)score at admission,the patients were classified into mildto-moderate group(n=123,78 cases of mild disease,45 cases of moderate disease)and severe group(n=27).All patients were monitored by aEEG.The aEEG score and serum Hcy level were compared between both groups.Receiver operating characteristic(ROC)curve was drawn to analyze the evaluation value of aEEG score and Hcy level on VCI conditions.The influencing factors of severe condition of VCI patients were explored by multivariate logistic regression analysis.Results The aEEG score in the severe group was lower while serum Hcy level was higher than that in the mild-to-moderate group(P<0.05).The areas under the curves(95%CI)of aEEG score,Hcy and their combination in predicting severe VCI were 0.870(0.814-0.926),0.806(0.698-0.913)and 0.915(0.780-0.968)respectively.The proportions of stroke history,diabetes mellitus history,multiple drug use and smoking history and levels of total cholesterol(TC),triacylglycerol(TG)and C-reactive protein(CRP)in the severe group were higher compared to the mild-to-moderate group(P<0.05).Reduced AEEG score,increased Hcy level,multiple drug use and concurrent diabetes mellitus were independent influencing factors for severe condition of VCI patients(P<0.05).Conclusion The decrease of aEEG score and increase of Hcy level are closely related to the disease severity of VCI patients.The two indexes can be used as sensitive markers to evaluate the disease severity of VCI patients.
作者
祖艳颖
兰希发
谭丽梅
杨帅
刘仕嵩
杜海龙
ZU Yanying;LAN Xifa;TAN Limei;YANG Shuai;LIU Shisong;DU Hailong(Department of Neurology,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China;Department of Neurosurgery,the Second Affiliated Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)
出处
《中华神经外科疾病研究杂志》
2026年第1期70-74,共5页
Chinese Journal of Neurosurgical Disease Research
基金
秦皇岛市科学技术研究与发展计划(202301A217)。
关键词
振幅整合脑电图
同型半胱氨酸
血管性认知障碍
病情严重程度
amplitude-integrated electroencephalogram
homocysteine
vascular cognitive impairment
disease severity
