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纤维蛋白原水平与轻度认知障碍患者认知特征的差异。

Fibrinogen Levels and Cognitive Profile Differences in Patients with Mild Cognitive Impairment.

机构信息

Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea,

Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.

出版信息

Dement Geriatr Cogn Disord. 2020;49(5):489-496. doi: 10.1159/000510420. Epub 2020 Nov 3.

Abstract

BACKGROUND

Fibrinogen is considered a marker of vascular pathology, indicating a weakened blood-brain barrier, and has a causative role in neuroinflammation and neurodegeneration. Little is known about the relationship between fibrinogen levels and cognitive function in patients with mild cognitive impairment (MCI). We aimed to investigate differences in cognitive profiles according to plasma fibrinogen levels in patients with MCI and the influence of plasma fibrinogen levels on cognitive decline.

METHODS

This retrospective cohort study included 643 patients with MCI: 323 patients in the high fibrinogen (high fib) group and 320 patients in the low fibrinogen (low fib) group. A multiple linear regression model was performed to compare cognitive test performance between groups. The Cox proportional hazard model was used to analyze the hazard ratio of fibrinogen level for disease progression.

RESULTS

The high fib group demonstrated poorer performance in attention, executive function, and confrontation naming than the low fib group. After adjustment for APOE genotype, the high fib group was associated with poor attention and executive function. After adjustment for vascular risk factors including body mass index, hypertension, diabetes mellitus, dyslipidemia, and smoking history, the high fib group showed declined attention and confrontation naming ability. High fibrinogen levels did not predict disease progression to CDR 1.

CONCLUSION

High plasma fibrinogen levels were associated with poor performance in attention in patients with MCI, regardless of APOE genotype or vascular risk factors.

摘要

背景

纤维蛋白原被认为是血管病理学的标志物,表明血脑屏障减弱,并且在神经炎症和神经退行性变中起因果作用。关于轻度认知障碍(MCI)患者的纤维蛋白原水平与认知功能之间的关系知之甚少。我们旨在研究 MCI 患者根据血浆纤维蛋白原水平的认知特征差异,以及血浆纤维蛋白原水平对认知下降的影响。

方法

本回顾性队列研究纳入了 643 名 MCI 患者:323 名高纤维蛋白原(高 fib)组和 320 名低纤维蛋白原(低 fib)组。采用多元线性回归模型比较组间认知测试表现。采用 Cox 比例风险模型分析纤维蛋白原水平对疾病进展的风险比。

结果

高 fib 组在注意力、执行功能和对抗命名方面的表现差于低 fib 组。在调整 APOE 基因型后,高 fib 组与注意力和执行功能差有关。在调整包括体重指数、高血压、糖尿病、血脂异常和吸烟史在内的血管危险因素后,高 fib 组显示注意力和对抗命名能力下降。高纤维蛋白原水平不能预测 CDR 1 的疾病进展。

结论

高血浆纤维蛋白原水平与 MCI 患者的注意力表现不佳有关,无论 APOE 基因型或血管危险因素如何。

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