本文選題：急性腔隙性腦梗死　切入點(diǎn)：胱抑素C　出處：《中國(guó)神經(jīng)精神疾病雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的探討急性腔隙性腦梗死患者血清胱抑素C(cystatin C,CysC)水平與認(rèn)知功能的相關(guān)性。方法123例住院治療的小血管病變所致急性腔隙性腦梗死患者根據(jù)CysC水平被分為低、中、高三組(各組均為n=41例)。根據(jù)認(rèn)知功能評(píng)測(cè)分為認(rèn)知功能正常組(n=64),血管性輕度認(rèn)知功能障礙(vascular mild cognitive impairment,VaMCI)組(n=36)及血管性癡呆(vascular dementia,VaD)組(n=23)。比較組間血清CysC、估算的腎小球?yàn)V過(guò)率(estimated glomerular filtration rate,eGFR)、血清肌酐(serum creatinine,Scr)、血脂、空腹血糖、糖化血紅蛋白A1C、血壓、美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分、簡(jiǎn)易精神狀態(tài)量表(MMSE)、阿爾茲海默病評(píng)定量表認(rèn)知分量表(ADAS-cog)、漢密爾頓抑郁量表(HAMD)得分的差異。采用Logistic回歸方法分析CysC與認(rèn)知功能障礙的相關(guān)性。結(jié)果高水平血清CysC組較中、低水平血清CysC組的MMSE得分更低(21.98±6.08 vs.25.02±4.69 vs.25.10±3.95),ADAS-cog得分更高(17.73±14.23 vs.12.51±10.39 vs.10.67±7.53),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。隨著血清CysC升高,SCr逐漸升高,e GFR逐漸減低(P0.05)。CysC(0.93±0.21 vs.1.10±0.45 vs.1.34±0.58)、MMSE、ADAS-cog在認(rèn)知正常組、VaMCI組和VaD三組間兩兩比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),認(rèn)知損害越重,CysC越高。多元Logistic回歸分析顯示CysC的回歸系數(shù)為7.06(P0.05)。結(jié)論血清CysC升高是小血管病變所致急性腔隙性腦梗死患者認(rèn)知功能障礙的危險(xiǎn)因素之一,且與認(rèn)知障礙的嚴(yán)重程度相關(guān)。
[Abstract]:Objective to investigate the correlation between serum cystatin cystatin CysC and cognitive function in patients with acute lacunar cerebral infarction. According to the cognitive function evaluation, the patients were divided into normal cognitive function group (n = 64), vascular mild cognitive impairment group (n = 36) and vascular dementia group (vascular dementia vat) group (n = 23). The serum CysCs were estimated by comparing the serum levels of CysC and glomerular filtration. Serum creatinine creatinine, serum creatinine, serum lipids, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, serum creatinine, Fasting blood glucose, glycosylated hemoglobin A1C, blood pressure, National Institutes of Health Stroke scale (NIHSS) score, The differences in scores of MMSE, Alzheimer's disease rating scale (AD) and Hamilton Depression scale (Hamd) were analyzed by Logistic regression method. Results compared with the high level serum CysC group, the correlation between CysC and cognitive dysfunction was analyzed by Logistic regression method. The MMSE score of low level CysC group was lower than that of low level CysC group (21.98 鹵6.08 vs.25.02 鹵4.69 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.25.10 鹵3.95 vs.12.51 鹵7.53), and the difference was statistically significant (P 0.05). With the increase of serum CysC, SCR increased, the level of GFR decreased gradually, P0.05. CysCine 0.93 鹵0.21 vs.1.10 鹵0.45 vs.1.34 鹵0.58 vs.1.34 鹵0.58 MAS-cog in the cognitive normal group and VaD group. The higher the cognitive impairment was, the higher the CysC was. The multiple Logistic regression analysis showed that the regression coefficient of CysC was 7.06 鹵P0.050.Conclusion the increase of serum CysC is one of the risk factors of cognitive dysfunction in patients with acute lacunar cerebral infarction caused by small vascular disease. And related to the severity of cognitive impairment.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院神經(jīng)內(nèi)科浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院腦科學(xué)協(xié)同創(chuàng)新中心;
【基金】：浙江省省部共建項(xiàng)目(項(xiàng)目編號(hào):2016152769)
【分類號(hào)】：R743.33

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