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将β淀粉样蛋白添加到全脑小血管疾病评分中可改善对小血管疾病患者认知障碍的预测。

Addition of Aβ to Total Cerebral Small Vessel Disease Score Improves the Prediction for Cognitive Impairment in Cerebral Small Vessel Disease Patients.

作者信息

Liu Jianping, Zhao Weihua, Gui Qinghong, Zhang Ying, Guo Zaiyu, Liu Wei

机构信息

Department of Neurology, Tianjin TEDA Hospital, Tianjin 300457, People's Republic of China.

Department of Neurosurgery, Tianjin TEDA Hospital, Tianjin 300457, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2021 Jan 25;17:195-201. doi: 10.2147/NDT.S289357. eCollection 2021.

Abstract

PURPOSE

To investigate the associations between concentrations of Aβ and Aβ and vascular cognitive impairment (VCI) in cerebral small vessel disease (CSVD) patients and evaluate the value of combination of levels of Aβ or Aβ and the total CSVD score in predicting VCI.

PATIENTS AND METHODS

A total of 199 CSVD patients were divided into VCI group and non-VCI group according to the criteria of VCI. Demographic data, MRI markers of CSVD, blood pressure, vascular risk factors, laboratory markers, and serum Aβ and Aβ concentration were collected. Univariate analysis was performed with the Student's -test, Mann-Whitney -test or Chi-square test. Variables with <0.10 in univariate analysis were then included in multivariate analysis that used a backward stepwise logistic regression model. The predictive values were assessed with receiver operating characteristic (ROC) curve.

RESULTS

VCI was determined in 112 CSVD patients (56.3%). Hyperlipidemia (OR: 1.618, 95% CI: 1.265-3.049), the total CSVD score (OR: 1.414, 95% CI: 1.213-2.278) and serum Aβ concentration (OR: 1.401, 95% CI: 1.212-1.946) were independent risk factors for VCI in CSVD patients with adjustment for age, education years, diabetes and fasting blood-glucose (FBG). The area under curves (AUCs) were 0.640 (SE: 0.040, 95% CI: 0.563-0.718), 0.733 (SE: 0.035, 95% CI: 0.664-0.802) and 0.827 (SE: 0.030, 95% CI: 0.768-0.887), respectively, for the total CSVD score, serum Aβ concentration and their combination applied in predicting VCI in CSVD patients. test demonstrated that the AUC of combination prediction was significantly higher than individual prediction (0.827 vs 0.640, =3.740, <0.001; 0.827 vs 0.733, =2.039, =0.021).

CONCLUSION

Combination of Aβ and total CSVD score could significantly elevate the predictive value of cognitive impairment in CSVD patients.

摘要

目的

探讨脑小血管病(CSVD)患者中淀粉样蛋白β(Aβ)浓度与Aβ及血管性认知障碍(VCI)之间的关联,并评估Aβ或Aβ水平与CSVD总评分联合预测VCI的价值。

患者与方法

根据VCI标准,将199例CSVD患者分为VCI组和非VCI组。收集人口统计学数据、CSVD的MRI标志物、血压、血管危险因素、实验室标志物以及血清Aβ和Aβ浓度。采用Student's -检验、Mann-Whitney -检验或卡方检验进行单因素分析。单因素分析中P<0.10的变量随后纳入多因素分析,多因素分析使用向后逐步逻辑回归模型。采用受试者工作特征(ROC)曲线评估预测价值。

结果

112例CSVD患者(56.3%)被判定为VCI。在对年龄、受教育年限、糖尿病和空腹血糖(FBG)进行校正后,高脂血症(OR:1.618,95%CI:1.265 - 3.049)、CSVD总评分(OR:1.414,95%CI:1.213 - 2.278)和血清Aβ浓度(OR:1.401,95%CI:1.212 - 1.946)是CSVD患者发生VCI的独立危险因素。CSVD总评分、血清Aβ浓度及其联合应用预测CSVD患者VCI的曲线下面积(AUC)分别为0.640(SE:0.040,95%CI:0.563 - 0.718)、0.733(SE:0.035,95%CI:0.664 - 0.802)和0.827(SE:0.030,95%CI:0.768 - 0.887)。检验表明,联合预测的AUC显著高于单独预测(0.827对0.640,Z = 3.740,P<0.001;0.827对0.733,Z = 2.039,P = 0.021)。

结论

Aβ与CSVD总评分联合可显著提高CSVD患者认知障碍的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0b9/7846822/8865fd3a05a3/NDT-17-195-g0001.jpg

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