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目的 分析脑小血管病(CSVD)认知功能障碍患者预后的相关影响因素。方法 选取2018年1月至2020年2月衡水市人民医院神经内科CSVD认知功能障碍患者512例，失访7例，根据痴呆情况分为痴呆组140例和非痴呆组365例，收集入选者临床资料，采用ROC曲线分析各项指标对痴呆的预测价值。结果 痴呆组饮酒、家族痴呆史、糖尿病、冠心病、甲状腺功能减退、独居、尿酸、同型半胱氨酸(Hcy)、缓激肽水平明显高于非痴呆组，规律运动、规律抗认知功能障碍治疗比例及基线蒙特利尔认知评估量表(MoCA)评分明显低于非痴呆组，差异有统计学意义(P<0.05,P<0.01)。基线尿酸、Hcy、缓激肽与基线MoCA评分呈负相关(P<0.01)。尿酸、Hcy、缓激肽三者联合预测痴呆的曲线下面积为0.897(95%CI:0.820～0.948,P=0.000)。结论 饮酒史、家族痴呆史、甲状腺功能减退、规律运动、居住情况、规律抗认知功能障碍治疗、基线MoCA评分、尿酸、Hcy、缓激肽是CSVD认知功能障碍患者进展为痴呆的影响因素，而尿酸、Hcy、缓激肽联合对痴呆具有良好的预测价值。
Abstract：Objective To analyze the factors influencing the prognosis of cerebral small vessel disease(CSVD) patients with cognitive impairment.Methods A total of 512 CSVD patients with cognitive impairment admitted in our department from January 2018 to February 2020 were subjected and then divided into dementia group(n=140) and non-dementia group(n=365) according to their dementia status.Their clinical data were collected.ROC curve were plotted to analyze the predictive value of each indicator for dementia.Results The dementia group had significantly larger proportions of alcohol consumption, family history of dementia, diabetes, coronary heart disease, hypothyroidism and living alone, and higher levels of uric acid, Hcy and bradykinin, lower proportions of regular exercise, receiving regular anti-cognitive impairment treatment and baseline MoCA score when compared with the non-dementia group(P<0.05,P<0.01).Baseline uric acid, Hcy, and bradykinin levels were negatively correlated with baseline MoCA score(P<0.01).The area under the curve for the combination of uric acid, Hcy and bradykinin level to predict dementia was 0.897(95%CI:0.820-0.948,P=0.000).Conclusion History of alcohol consumption, family history of dementia, hypothyroidism, regular exercise, housing status, regular anti-cognitive impairment treatment, baseline MoCA score, uric acid, Hcy, and bradykinin are influencing factors in the progression to dementia in CSVD patients with cognitive impairment, and the combination of uric acid, Hcy, and bradykinin levels has good predictive value for dementia.
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基本信息:
中图分类号:R743;R749.13
引用信息:
[1]吴睿,甄娜,王欣丽,等.脑小血管病认知功能障碍患者进展为痴呆的影响因素分析[J].中华老年心脑血管病杂志,2023,25(06):576-579.
基金信息:
河北省医学科学研究课题计划(20211563)