| 金庭如,笱玉兰.探究脑小血管病合并认知功能障碍与载脂蛋白的相关性研究[J].安徽医药,2025,29(8):1630-1634. |
| 探究脑小血管病合并认知功能障碍与载脂蛋白的相关性研究 |
| Research on exploring the correlation of cerebral small vessel disease with cognitive impairment and apolipoproteins |
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| DOI：10.3969/j.issn.1009-6469.2025.08.029 |
| 中文关键词: 大脑小血管疾病 认知障碍 载脂蛋白 载脂蛋白 A-I 载脂蛋白 B |
| 英文关键词: Cerebral small blood vessel disease Cognitive impairment Apolipoprotein Lipoprotein A-Ⅰ Lipoprotein B |
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| 中文摘要: |
| 目的探讨脑小血管病( CSVD)病人外周血载脂蛋白 B(ApoB)、载脂蛋白 A-Ⅰ(ApoA-Ⅰ)与认知功能障碍的相关性，分析 CSVD合并认知障碍( CSVD-VCI)的潜在影响因素。方法选取 2020年 12月至 2023年 12月武汉市第一医院住院部收治的 128例 CSVD病人作为研究对象，根据是否伴有认知障碍分为认知障碍组( 66例)和认知正常组( 62例)。收集病人的年龄、性别、受教育年限、既往史(高血压史、糖尿病、高脂血症、动脉粥样硬化、吸烟史、饮酒史)、实验室资料和影像学检查，采用改良 Fazekas对脑白质高信号进行分级( 1，2，3级)认知功能由两名专业的神经内科医师对 CSVD病人进行专业量表评估。采用多因素 logistic回归分析 CSVD病人发生认知障碍的，危险因素，采用多重线性回归分析潜在的影响因素与 CSVD-VCI之间的相关性。结果 CSVD认知障碍组病人 ApoB/ApoA-Ⅰ 0.86±0.18、甘油三酯( TG)(1.66±0.55)mmol/L高于非认知障碍组［0.80±0.06、(1.39±0.48)mmol/L］，蒙特利尔认知量表( MoCA)评分( 17.32±5.03)分、简易精神状态检查表( MMSE)评分( 23.11±4.95)分、高密度脂蛋白( HDL)(1.18±0.25)mmol/L低于非认知障碍组［(28.55±0.88)分、(28.77±0.86)分、(1.28±0.09)mmol/L］(P<0.05)。多因素 logistic回归显示 ApoB/ApoA-Ⅰ［OR=27.32，95%CI:(1.09，682.33)，P=0.044］、 HDL［OR=0.07，95%CI:(0.01，0.63)，P=0.018］是 CSVD病人发生认知障碍的危险因素( P<0.05)。多重线性回归显示 CSVD病人外周血 ApoB/ApoA-Ⅰ与 MoCA评分( β= .24.76，t=.6.63，P<0.001)、 MMSE评分( β=.21.01，t=.9.05，P<0.001)均呈负相关， HDL与 MoCA评分、 MMSE评分之间差异无统计学意义。结论 CSVD-VCI病人外周血 ApoB/ApoA-Ⅰ、HDL水平明显升高， ApoB/ApoA-Ⅰ是 CSVD-VCI病人发生认知障碍的危险因素，其外周血 ApoB/ApoA-Ⅰ与认知功能呈负相关。 |
| 英文摘要: |
| Objective To investigate the correlation between apolipoprotein B (ApoB) and apolipoprotein A-Ⅰ (ApoA-Ⅰ) and cogni-tive dysfunction in peripheral blood of patients with cerebral small vessel disease (CSVD), in order to analyze the potential influencingfactors of CSVD complicated with cognitive impairment (CSVD-VCI).Methods A total of 128 patients with CSVD admitted to the in-patient department of Wuhan No.1 Hospital from December 2020 to December 2023 were selected as the study subjects, and they wereassigned into cognitive impairment group (66 cases) and cognitive normal group (62 cases) according to whether they were accompaniedby cognitive impairment. The age, gender, years of education, past medical history (hypertension, diabetes, hyperlipidemia, atheroscle-rosis, history of smoking and drinking), laboratory data and imaging examinations were collected, and the modified Fazekas were usedto grade the white matter hyperintensity (grades 1,2,3), and the cognitive function was evaluated by two professional neurologists on aprofessional scale for CSVD patients. Multivariate logistic regression was used to analyze the risk factors of cognitive impairment in CS-VD patients, and multiple linear regression was used to analyze the correlation between potential influencing factors and CSVD-VCI. Results The ApoB/ApoA-Ⅰ 0.86±0.18, triglyceride (TG) (1.66±0.55) mmol/L of the CSVD cognitive impairment group were higher than those of the non-cognitive impairment group [0.80±0.06, (1.39±0.48) mmol/L], and the Montreal cognitive assessment (MoCA)score (17.32±5.03) points, Mini-mental state examination (MMSE) score (23.11±4.95) points and high density lipoprotein (HDL) (1.18±0.25) mmol/L were lower than those of the non-cognitive impairment group [(28.55±0.88) points, (28.77±0.86) points and HDL (1.28± 0.09) mmol/L] (P<0.05). Multivariate logistic regression showed that ApoB/ApoA-Ⅰ[OR=27.32, 95%CI:(1.09, 682.33), P=0.044] and HDL [OR=0.07, 95%CI:(0.01, 0.63), P=0.018] were risk factors for cognitive impairment in CSVD patients (P<0.05). Multiple linear re-gression showed that peripheral blood ApoB/ApoA-Ⅰ and MoCA score (β=.24.76, t=.6.63, P<0.001) and MMSE score (β=.21.01, t= .9.05, P<0.001) were negatively correlated in CSVD patients, and there was no statistical significance between HDL and MoCA scoreand MMSE score. Conclusion ApoB/ApoA-Ⅰ and HDL levels in peripheral blood of CSVD-VCI patients were significantly in-creased, and ApoB/ApoA-Ⅰ is a risk factor for cognitive impairment in CSVD-VCI patients, and peripheral ApoB/ApoA-Ⅰ were nega-tively associated with cognitive function. |
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