急性脑梗死患者血清淀粉样蛋白A与认知功能障碍的相关性研究

目的 探讨血淀粉样蛋白A( SSA )水平与急性脑梗死后认知功能障碍的关系。方法 对480例脑梗死患者进行蒙特利尔认知功能评估,依据评估结果分为无认知障碍组及认知障碍组。对潜在的认知功能危险因素进行统计分析,将有统计学意义的因素与MoCA评分进行多元线性回归分析。并对血SSA水平与脑梗死后认知功能障碍的相关性进行分析。结果 性别、酗酒、糖尿病、糖尿病肾病、关键部位梗死、受教育程度和血SSA浓度在认知功能障碍组和非认知功能障碍组间具有统计学差异(P<0.05)。MoCA评分与血SSA水平呈负相关(r=-0.63,P<0.05),而与性别、糖尿病、糖尿病肾病、关键部位梗死、受教育程度呈正相关。ROC曲线分析结果显示,血清SSA阈值为0.9 mg/L时,曲线下面积为0.894。检测的敏感性和特异性分别为78.2%和66.7%。结论 血SSA在认知功能障碍的预测中具有一定的临床应用价值。

Correlation study between serum amyloid protein and acute cerebral infarction

ObjectiveTo evaluate the relationship between serum amyloid A and cognitive impairment after acute cerebral infarction.Methods Based on the montreal cognitive assessment, 480 patients were divided into two groups: patients with impairment cognitive and patients with no-impairment cognitive. Clinical biochemical parameters and potential risk factors were analysed by statistic analysis. The indicators of statistically significant and score of MoCA were conducted to assessment for multiple linear regression analysis. The correlation of serum amyloid A and cognitive impairment were evaluated.Results A significant difference in risk factors, including gender, alcoholism, diabetes, diabetic nephropathy, brain infarction, higher education,and concentration of serum amyloid A, was observed between impairment cognitive group and no-impairment cognitive group(P<0.05). Concentration of serum amyloid A showed inverse correlation with score of MoCA(r=-0.63,P<0.05). Score of MoCA showed positive correlation with gender, diabetes, diabetic nephropathy, brain infarction, and higher education. Concentration of serum amyloid A for prediction patients with cognitive impairment showed that the area under the ROC curve was0.894(cut-off value was 0.9 mg/L). The sensitivity and specificity of serum amyloid A for prediction patients with cognitive impairment was 78.2% and 66.7%, respectively.Conclusion Serum amyloid A would be a clinically useful marker for prediction cognitive impairment.