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脑室周围高信号和胱抑素 C 对非痴呆老年中国人不同认知领域的影响。

Impact of periventricular hyperintensities and cystatin C on different cognitive domains in the population of non-demented elderly Chinese.

机构信息

Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.

Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.

出版信息

J Clin Neurosci. 2019 Oct;68:201-210. doi: 10.1016/j.jocn.2019.05.053. Epub 2019 Jul 12.

Abstract

OBJECTIVES

To investigate the impact of periventricular hyperintensities and serum cystatin C on mild cognitive impairment to provide a basis for the investigation of the pathogenesis.

METHOD

286 patients enrolled the study and underwent an examination in Shanghai Fifth People's Hospital from June 2017 to June 2018. The participants' cognitive function was evaluated by different cognitive domains using of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), auditory verbal learning test, Huashan version (AVLT-H), digit span test (DST), symbol digit modalities test (SDMT), trail making test (TMT) and verbal fluency test (VFT). We measured the levels of serum cystatin C at the department of clinical laboratory in Shanghai Fifth People's Hospital and each subject took an MRI examination in the Department of Radiology of Shanghai Fifth People's Hospital. Multivariate linear regression analyses were used to assess the relationship of cognitive score and the level of cystatin C and periventricular hyperintensities severity. All statistical analyses were performed using the SPSS system.

RESULTS

Among 286 eligible participants, 203 (71.0%) were enrolled to further analysis, including 69 male and 134 female (Mean age 67.93 ± 6.19 years). Significant predictors of severe periventricular hyperintensities (PVH) were older age and hypertension. Significant predictors of severe deep white matter hyperintensities (DWMH) were older age only. PVH severity was independently associated with mild cognitive impairment and that the primary impairment was executive function and processing speed. DWMH had no significant effect on cognitive function. Cystatin C only affected the overall cognitive level, and the relationship with WMH severity was not significant.

CONCLUSIONS

We demonstrated that in the chinese non-demented elderly, the severity of PVH was independent and significant associated with mild cognitive impairment and that the primary impairment was executive capacity and processing speed, while cystatin C may be an independent risk factor for overall cognitive impairment.

摘要

目的

探讨脑白质疏松症和血清胱抑素 C 对轻度认知障碍的影响,为探讨其发病机制提供依据。

方法

选取 2017 年 6 月至 2018 年 6 月在上海市第五人民医院就诊的 286 例患者,采用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、听觉词语学习测验、华山版(AVLT-H)、数字跨度测验(DST)、符号数字模式测验(SDMT)、连线测验(TMT)和词语流畅性测验(VFT)对不同认知域进行认知功能评估。采用上海第五人民医院检验科检测血清胱抑素 C 水平,上海第五人民医院放射科行 MRI 检查。采用多元线性回归分析评估认知评分与胱抑素 C 水平及脑白质疏松症严重程度的关系。所有统计分析均采用 SPSS 系统进行。

结果

在 286 名符合条件的参与者中,有 203 名(71.0%)被纳入进一步分析,其中男性 69 名,女性 134 名(平均年龄 67.93±6.19 岁)。严重脑白质疏松症(PVH)的显著预测因素为年龄较大和高血压。严重深部脑白质高信号(DWMH)的显著预测因素仅为年龄较大。PVH 严重程度与轻度认知障碍独立相关,主要损害为执行功能和处理速度。DWMH 对认知功能无显著影响。胱抑素 C 仅影响整体认知水平,与脑白质高信号严重程度无显著关系。

结论

我们表明,在中国非痴呆老年人中,PVH 的严重程度与轻度认知障碍独立且显著相关,主要损害为执行能力和处理速度,而胱抑素 C 可能是整体认知障碍的独立危险因素。

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