血液生物学指标对脑小血管病患者认知障碍的诊断价值研究

背景 既往研究表明,血液生物学指标与脑小血管病性认知障碍有关,但其对脑小血管病性认知障碍诊断价值的研究报道较少.目的 探讨血液生物学指标对脑小血管病(CSVD)患者认知障碍的诊断价值.方法 选取2019年6月—2020年6月在河南科技大学第二附属医院神经内科住院治疗的CSVD患者235例,根据入院后24 h内蒙特利尔认...

Diagnostic Value of Blood Biomarkers for Cognitive Impairment in Patients with Cerebral Small Vessel Disease

Background Previous studies have shown that blood biomarkers are related to cognitive impairment of cerebral small vessel disease(CSVD),but there are few reports on the diagnostic value of blood biomarkers for cognitive impairment of CSVD.Objective To evaluate the diagnostic value of blood biomarkers for cognitive impairment in patients with CSVD.Methods A total of 235 patients with CSVD who were hospitalized in the Department of Neurology,the Second Affiliated Hospital of Henan University of Science and Technology from June 2019 to June 2020 were selected,and according to the score of Montreal Cognitive Assessment(MoCA)scale,they were divided into cognitive disorder group(MoCA scale score was<26,n=127)and normal cognition group(MoCA scale score was≥26,n=108).The general information of patients were collected.According to the practical experience of previous studies and practicability of the study,the author selected the blood biomarkers which are easy to obtain and cheap to detect,including lipid indexes[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL)and low density lipoprotein(LDL)],serum uric acid(SUA),homocysteine(Hcy),fibrinogen(FIB)and D-dimer.The influencing factors of cognitive impairment in CSVD patients were analyzed by multivariate Logistic regression analysis,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of SUA,Hcy,FIB and their combination for diagnosing cognitive impairment in patients with CSVD.Results The proportion of patients with smoking history and drinking history and the levels of SUA,Hcy,FIB in the cognitive disorder group were higher than those in the normal cognition group(P<0.05).Multivariate Logistic regression analysis showed that drinking history[OR=2.27,95%CI(1.07,4.81)],SUA[OR=1.02,95%CI(1.01,1.02)],Hcy[OR=1.26,95%CI(1.16,1.37)],FIB[OR=3.56,95%CI(1.87,6.79)]were independent influencing factors of cognitive impairment in CSVD patients.ROC curve analysis results showed that the area under curve(AUC)of SUA,Hcy and FIB in the diagnosis of cognitive impairment in CSVD patients was 0.729,0.781 and 0.703,respectively,and the AUC of the three combined diagnosis of cognitive impairment in CSVD patients was 0.849.Conclusion SUA,Hcy and FIB are independent influencing factors of cognitive impairment in patients with CSVD.The diagnostic value of the combination of SUA,Hcy and FIB for cognitive impairment in patients with CSVD is moderate,but is higher than that of a single index.