脑小血管病患者血清 CTRP1和同型半胱氨酸水平对血管性轻度认知障碍预测价值的研究

目的　探讨血补体 C1q/肿瘤坏死因子相关蛋白 1(CTRP1)，血同型半胱氨酸（ Homocysteine，Hcy）预测脑小血管疾病（ cerebral small vessel disease，CSVD）患者血管性轻度认知障碍（ vascular mild cognitive impairment，VaMCI）的临床价值。方法　选取 2015年 12月～ 2019年 12月沧州市人民医院收治的 98例 CSVD患者，采用蒙特利尔评估表（Montreal cognitive assessment，MoCA）对其进行认知能力检查，分为 VaMCI组（n=56）和认知正常组（ n=42）。分别采取 Logistic回归分析以及 Pearson相关性分析 CTRP1、血同型半胱氨酸与 VaMCI之间的相关性。结果　VaMCI组 Hcy，CTRP1以及 UA水平均高于认知正常组 (Hcy:22.02±3.74μmol/L vs 18.43±3.52μmol/L，CTRP1:162.54±14.85ng/ ml vs 135.26±13.41ng/ml，UA:360.27±23.28μmol/L vs 320.55±20.23μmol/L)，差异均有统计学意义（ t=4.822，9.377，

Study on the Predictive Value of Serum CTRP1 and Homocysteine Levels in Patients with Cerebral Small Vessel Diseases inVascular Mild Cognitive Impairment

Objective　To investigate the clinical value of vascular mild cognition in patients with cerebral small vessel disease(CSVD) by blood complement C1q / tumor necrosis factor related protein 1 (CTRP1) and blood homocysteine (Hcy) in predictingvascular mild cognitive impairment (VaMCI) in patients with cerebral small blood vessels. Methods　From December 2015 toDecember 2019, 98 CSVD patients admitted to Cangzhou People’s Hospital were selected as the research subjects, and theircognitive abilities were examined using the Montreal cognitive assessment (MoCA). There were 56 cases in VaMCI group, 42cases in normal cognitive group and 60 cases in healthy control group. Logistic regression analysis and Pearson correlationanalysis were used to analyze the correlation between CTRP1, blood homocysteine and VaMCI. Results　The levels of Hcy,CTRP1 and UA in the VaMCI group were higher than those in the cognition normal group （Hcy:22.02±3.74μmol/L vs18.43±3.52μmol/L, CTRP1:162.54±14.85ng/ml vs 135.26±13.41ng/ml, UA:360.27±23.28μmol/L vs 320.55±20.23μmol/L）, the differences were statistically significant（t=4.822，9.377，8.833, P<0.001). Logistic regression analysis results showedthat Hcy, CTRP1 and UA were all risk factors for VaMCI in CSVD patients (Hcy:OR=2.782, 95%CI:1.515~5.107,P=0.001;CTRP1:OR=3.401, 95%CI:1.729~6.687，P=0.000; UA:OR=2.335, 95%CI:1.325~4.114, P=0.003); and that in VaMCIgroup, Hcy and CTRP1 were negatively correlated with MoCA total score (r = -0.415, -0.467, P <0.05). In the VaMCI group,Hcy and CTRP1 levels were negatively correlated with sub-items such as memory, language, visual space, and executive ability (r= -0.402, -0.436；- 0.365,- 0.379; -0.512，-0.536, all P <0.05). Conclusion　CSVD patients with VaMCI serum CTRP1 andHcy expression levels were significantly increased, and both are independent risk factors for VaMCI in CSVD patients, both ofwhich are significantly related to the patient’s MoCA total score, memory, language, visual space and executive ability. Earlydetection of CSVD serum CTRP1 and Hcy levels are of great significance for preventing cognitive dysfunction.