Xu G, Zhang H, Zhang S, Fan X, Liu X
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China.
Int J Clin Pract. 2008 Jul;62(7):1070-5. doi: 10.1111/j.1742-1241.2007.01268.x. Epub 2007 Oct 4.
This study was aimed to investigate the relationship between plasma fibrinogen level and risk for cognitive decline and dementia in patients with mild cognitive impairment (MCI). Elderly patients with suspected cognitive impairment were screened and evaluated periodically. One hundred and eighty-five patients who met the criteria for MCI were enrolled. Blood coagulation functions and plasma fibrinogen levels were measured at baseline. Hyperfibrinogenaemia was defined as plasma fibrinogen > or =3.0 g/l. Global cognitive function was assessed serially with Mini-Mental State Examination (MMSE). The enrolled patients were followed for 2 years to observe if dementia was developed. There were 185 patients diagnosed as MCI, of which 17 (9.2%) deceased, 15 (8.1%) lost to follow-up, and 68 (36.8%) developed dementia during follow-up. Mean of MMSE score of the enrolled patients declined significantly during follow-up (22.0 +/- 3.0 vs. 18.1 +/- 5.8, p < 0.001). Patients with hyperfibrinogenaemia at baseline had greater MMSE decrement during follow-up than patients with normal fibrinogen level (-5.4 +/- 5.4 vs. -3.5 +/- 4.5, p < 0.05). Linear regression indicated that plasma fibrinogen level was associated with cognitive decline (R = 0.17, p < 0.05). Patients with hyperfibrinogenaemia had an increased risk for dementia and vascular dementia compared with patients with normal level of plasma fibrinogen (log rank test, p < 0.05). There was a trend that hyperfibrinogenaemia also increased risk for dementia of Alzheimer's type (p = 0.061). It can be concluded that plasma fibrinogen level may be associated with cognitive decline, and hyperfibrinogenaemia may increase risk for dementia in patients with MCI.
本研究旨在探讨轻度认知障碍(MCI)患者血浆纤维蛋白原水平与认知功能减退及痴呆风险之间的关系。对疑似认知障碍的老年患者进行定期筛查和评估。纳入185例符合MCI标准的患者。在基线时测量凝血功能和血浆纤维蛋白原水平。高纤维蛋白原血症定义为血浆纤维蛋白原≥3.0g/L。采用简易精神状态检查表(MMSE)连续评估整体认知功能。对纳入的患者随访2年,观察是否发生痴呆。共有185例患者被诊断为MCI,其中17例(9.2%)死亡,15例(8.1%)失访,68例(36.8%)在随访期间发生痴呆。随访期间,纳入患者的MMSE评分均值显著下降(22.0±3.0对18.1±5.8,p<0.001)。基线时高纤维蛋白原血症患者在随访期间的MMSE评分下降幅度大于纤维蛋白原水平正常的患者(-5.4±5.4对-3.5±4.5,p<0.05)。线性回归表明血浆纤维蛋白原水平与认知功能减退相关(R=0.17,p<0.05)。与血浆纤维蛋白原水平正常的患者相比,高纤维蛋白原血症患者发生痴呆和血管性痴呆的风险增加(对数秩检验,p<0.05)。高纤维蛋白原血症也有增加阿尔茨海默病型痴呆风险的趋势(p=0.061)。可以得出结论,血浆纤维蛋白原水平可能与认知功能减退相关,高纤维蛋白原血症可能增加MCI患者发生痴呆的风险。