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

doi:10.3969/j.issn.1006-6233.2023.01.028

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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.

Key words： Acute cerebral infarction Cognitive impairment Correlation Risk factors

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.01.028 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I1/147

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