血浆同型半胱氨酸和血清神经元特异性烯醇化酶对轻度血管性认知障碍的预测价值

目的探讨血浆同型半胱氨酸(Hcy)和血清神经元特异性烯醇化酶(NSE)对轻度血管性认知障碍(VMCI)的预测价值。方法选取VMCI患者51例,正常对照组45例,完成神经心理学评估,头颅MRI或CT检查,测定血浆Hcy和血清NSE水平。结果 (1)两组间年龄、性别、受教育程度差异无统计学意义(P>0.05)。与正常对照组比较,VMCI患者Hcy和NSE水平明显升高,差异有统计学意义(P<0.05);(2)VMCI患者中,LA-VMCI(23例)和LI-VMCI(28例),两组间Hcy和NSE水平差异无统计学意义(P>0.05);(3)相关性分析显示,血浆Hcy与血清NSE呈正相关(r=0.657,P=0.008);(4)以Hcy来预测VMCI,其曲线下AUC为0.871(P=0.000,95%CI 0.753～0.948),OPP=15.89μmol.L-1,敏感性为86.5%,特异性为87.1%,阳性预测值86.7%,阴性预测值71.3%。以NSE来预测VMCI,其曲线下AUC为0.866(P=0.000,95%CI 0.756～0.930),OPP=17.82μg.L-1,敏感性为87.8%,特异性为85.3%,阳性预测值91.5%,阴性预测值为78.7%。结论血浆Hcy和血清NSE对VMCI有一定预测价值。

The prognostic values of the homocysteine and neuron - specific eoolase in patients of vascular mild cognitive impairment ： a clinical study

Objective To investigate the prognostic values of the homocysteine and neuron - specific eoolase in patients of vascular mild cognitive impairment. Methods We selected 51 cases of VMCI patients and 45 cases of normal control group. We completed the neuropsychological assessment, cranial MRI or CT and the determination of plasma Hcy and serum NSE levels. Results ① Between the two groups, there were no significant difference in age, gender and education （P 〉 0.05）. Compared with normal control group, VMCI patients were significantly increased in the Hey and NSE levels （P 〈0.05） ;②In the VMCI patients, there were LA - VMCI （23 cases） and LI- VMC1 （28 cases） . There were no significant difference in the Hey and NSE levels between the two groups （P 〉 0.05） ; ③Correlation analysis： plasma Hcy was positive correlation to serum NSE （r = . 657, P = 0.008） ; ④To predict VMCI from Hcy, the area under curve was 0. 871 （ P = 0. 000,95% confidence interval 0. 753 to 0.948）, the cutoff value was 15.89μmol . L-1. The sensitivity was 86. 5%, the specificity was 87. 1%. The positive predictive value was 86.7% , and the negative predictive value was 71.3%. To predict VMCI from NSE, the area under the curve was 0. 866 （P = 0. 000,95% confidence interval 0. 756 to 0. 930）, the cutoff value was 17.82μg. L-1. The sensitivity was 87.8%, the specificity was 85.3%. The positive predictive value was 91.5 % and the negative predictive value was 78.7%. Conclusion Plasma homocysteine and serum neuron-specific enolase have some predictive value of vascular mild cognitive impairment.