血清淀粉样蛋白A和同型半胱氨酸水平与皮质下缺血性血管病认知损害的关系

doi:10.3969/j.issn.1006-6233.2021.08.014

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Abstract Objective: To analyze the relationship between levels of serum amyloid A (SAA) and homocysteine (Hcy) and cognitive impairment (CI) in subcortical ischemic vascular disease (SIVD). Methods: The clinical data of 152 patients with SIVD in our hospital were retrospectively analyzed. According to the occurrence of CI, they were divided into non-CI group and CI group. The baseline data, levels of serum SAA and Hcy and intracranial hemodynamic indicators [middle cerebral artery (MCA)-pulsatility index (PI), anterior cerebral artery (ACA)-PI] were compared between the two groups. Receiver operating characteristic curve (ROC curve) was used to assess the diagnostic value of serum SAA, Hcy and intracranial hemodynamic indicators on CI in SIVD, and Logistic regression model was used to analyze the risk factors of CI in SIVD. Results: Among 152 patients with SIVD, there were 63 cases (41.45%) in CI group and 89 cases (58.55%) in non-CI group. There were no statistically significant differences between the two groups in terms of gender, age, smoking history, drinking history, hypertension and lipid metabolism disorders (P>0.05). The years of education in CI group was lower than that in non-CI group (P<0.05), and the prevalence rate of diabetes mellitus, serum SAA, Hcy, MCA-PI and ACA-PI were higher than those in CI group (P<0.05) . By ROC curve analysis, serum SAA, Hcy, MCA-PI and ACA-PI had high diagnostic value on CI in SIVD (AUC=0.859, 0.847, 0.871, 0.666, P<0.05), and their cut-off values were 291.58 mg/L, 19.77 μmol/L, 1.04 and 0.96 respectively. Logistic regression analysis showed that education < 9 years, diabetes mellitus, SAA≥291.58mg/L, Hcy≥19.77μmol/L, MCA-PI≥1.04 and ACA-PI≥0.96 were all independent risk factors for CI in SIVD (OR=2.113, 2.596, 2.201, 2.151, 2.275, 1.925, P<0.05). Conclusion: SIVD patients with low education level or diabetes mellitus are at higher risk of CI. The detection of serum SAA, Hcy and intracranial hemodynamics is beneficial to determine the occurrence of CI in patients with SIVD. It is necessary to actively monitor the above indicators in clinical practice so as to detect CI in time.

Key words： Subcortical ischemic vascular disease Cognitive impairment SAA Hcy Intracranial hemodynamics

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.08.014 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I8/1299

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