Abstract：Objective: To analyze the correlation between serum homocysteine (Hcy), glycosylated hemoglobin (HbA1c) and serum adiponectin (APN) and cognitive impairment in patients with acute cerebral infarction (ACI). Methods: 102 patients with acute cerebral infarction treated in the hospital between July 2018 and February 2022 were selected as observation subjects, and the above patients were divided into normal cognition group (n=57, MMSE score ≥ 27 points) and cognitive impairment group (n=45, MMSE score<27 points) according to the Mini-Mental State Scale (MMSE). The general data of the two groups of patients were compared, and the laboratory indicators such as Hcy, HbA1c and APN were measured. The risk factors of cognitive impairment in patients with ACI were analyzed. According to MMSE, the patients with cognitive impairment were classified into mild group (17 cases), moderate group (15 cases) and severe group (13 cases). The changes in the above serum indicators in different groups of patients were compared, and their correlation with cognitive impairment and severity was analyzed. Results: There were no statistically significant differences in the course of disease, years of education, gender, drinking history, location of cerebral infarction, triglyceride (TG) and total cholesterol (TC) between normal cognition group and cognitive impairment group (P>0.05). The age in cognitive impairment group was older than that in normal cognition group, and the proportions of patients with hypertension, coronary heart disease and diabetes mellitus were higher than those in normal cognition group, and the levels of low-density lipoprotein cholesterol (LDL-C), Hcy and HbAlc were higher compared to normal cognition group (P<0.05). Hypertension (OR=1.442, 95%CI: 1.131~1.839), coronary heart disease (OR=1.342, 95%CI: 1.069~1.684), diabetes mellitus (OR=1.493, 95%CI: 1.027~2.171) and elevated levels of Hcy (OR=1.525, 95%CI: 1.053~2.209) and HbAlc (OR=1.650, 95%CI: 1.100~2.476) were risk factors for cognitive impairment in patients with ACI, and elevated APN level (OR=0.659, 95%CI: 0.458~0.949) was a protective factor for cognitive impairment in patients with ACI (P<0.05). The levels of Hcy and HbAlc in moderate group were higher than those in mild group while the APN was lower than that in mild group (P<0.05). The levels of Hcy and HbAlc were higher in severe group than those in mild and moderate groups while the APN was lower than that in mild and moderate groups (P<0.05). Hcy and HbAlc were negatively correlated with MMSE score (r=-0.569, -0.451, P<0.05), and APN was positively correlated with MMSE score (r=0.447, P<0.05). Conclusion: Elevated levels of Hcy and HbAlc are risk factors for cognitive impairment in patients with ACI, and high APN is a protective factor for cognitive impairment. The levels of Hcy and HbAlc are increased with the aggravation of cognitive impairment and are negatively correlated with cognitive function score, while APN is decreased with the aggravation of cognitive impairment and is positively correlated with cognitive function score. These indicators are helpful to guide the evaluation of cognitive impairment in patients with ACI.
范驰, 马珊珊, 张薇, 胡晓颖, 王瑞萍. 血清Hcy HbA1c及APN与急性脑梗死患者认知功能障碍的相关性分析[J]. 河北医学, 2023, 29(1): 147-153.
FAN Chi, MA Shanshan, ZHANG Wei, et al. Correlation of Serum Hcy, HbA1c and APN with Cognitive Impairment in Patients with Acute Cerebral Infarction. HeBei Med, 2023, 29(1): 147-153.
[1] 姚晓濛,杨小营,马莉.血清PTX3水平在急性脑梗死患者动态变化与远隔缺血后神经保护的相关性分析[J].河北医学,2022,28(3):417-421. [2] 丁娜,张志军.脑梗死患者认知功能障碍与血清胱抑素C、血尿酸水平的相关性分析[J].成都医学院学报,2018,13(6):686-689. [3] Yan W,Fan J,Zhang X,et al.Decreased neuronal synaptosome associated protein 29 contributes to poststroke cognitive impairment by disrupting presynaptic maintenance[J].Theranostics,2021,11(10):4616-4636. [4] 李谦,尚瑞华,李星,等.急性脑梗死患者血清脂联素水平与认知功能障碍的相关性[J].神经疾病与精神卫生,2022,22(2):106-111. [5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682. [6] 周小炫.中文版简易智能精神状态检查量表在脑卒中患者中的信效度初步研究[D].福建中医药大学,2015. [7] 欧春影,李传玲,安晓雷,等.脑卒中后血管性认知功能障碍的危险因素分析及发病风险预测[J].山东医药,2019,59(20):68-71. [8] Zanon Zotin MC,Sveikata L,Viswanathan A,et al.Cerebral small vessel disease and vascular cognitive impairment:from diagnosis to management[J].Curr Opin Neurol,2021,34(2):246-257. [9] 张德绸,葛建华,叶丽莎,等.脑小血管病致血管性认知功能障碍相关因素分析[J].中国实用神经疾病杂志,2020,23(17):1520-1524. [10] Li R,Weng H,Pan Y,et al.Relationship between homocysteine levels and post-stroke cognitive impairment in female and male population:from a prospective multicenter study[J].Transl Int Med,2021,9(4):264-272. [11] He K,Nie L,Ali T,et al.Adiponectin alleviated Alzheimer-like pathologies via autophagy-lysosomal activation[J].Aging Cell,2021,20(12):13514. [12] Liu Y,Zhu J,Deng X,et al.Serum level of lipoprotein-associated phospholipase A2 is a potential biomarker of vertebrobasilar dolichoectasia and its progression to cerebral infarction[J].Neurol Sci,2021,42(2):599-605. [13] 许莉,李慧英.脑梗死急性期患者糖化血红蛋白和纤维蛋白原水平与认知功能障碍的关系[J].中华老年心脑血管病杂志,2018,20(6):627-630.
2023, Vol. 29 
冀公网安备13080202000677号