Dobrynina L A, Shabalina A A, Shamtieva K V, Krotenkova M V, Kalashnikova L A
Research Center of Neurology, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(3):77-85. doi: 10.17116/jnevro202112103177.
AIM/: To assess individual values of salt sensitivity and osmotic fragility on the patient's erythrocytes and evaluate predictive ability of these parameters in the development of cerebral small vessel disease (CSVD).
The study included 73 patients with CSVD (48 women, mean age 60.1±6.5 years) and 19 volunteers (14 women, mean age 56.9±5.4 years). Their erythrocytes were used for the measurement of salt-sensitivity by a modified salt blood test and of osmotic fragility by the classical osmotic fragility test. Binary logistic regression was used to assess the ability of salt-sensitivity and osmotic fragility to predict CSVD development. ROC analysis was used to find out the optimal threshold values of these predictors, their sensitivity and specificity.
An increase in salt sensitivity (cut-off: 8.5 mm/h; sensitivity 64%, specificity 74%) and osmotic fragility (cut-off: 0.62 u.a.; sensitivity 52%, specificity 90%) or their simultaneous use ( of the model <0.000001, cut-off 0.62; sensitivity 88%, specificity 68%) are the independent predictors of CSVD. An increase in salt sensitivity and osmotic fragility is also independently associated with the acceleration of severity of white matter hyperintensities according to Fazekas stages (=0.019 and 0.004, respectively).
The possibility of prediction of CSVD according to an increase in salt sensitivity and osmotic fragility allows us to consider them as the risk factors of CSVD. The standardization of these tests for use in clinical practice is necessary to identify the risk group for CSVD and its individual prevention.
评估患者红细胞的盐敏感性和渗透脆性的个体值，并评估这些参数在脑小血管疾病（CSVD）发生发展中的预测能力。
该研究纳入了73例CSVD患者（48例女性，平均年龄60.1±6.5岁）和19名志愿者（14例女性，平均年龄56.9±5.4岁）。采用改良盐血试验测量其红细胞的盐敏感性，采用经典渗透脆性试验测量其红细胞的渗透脆性。采用二元逻辑回归评估盐敏感性和渗透脆性预测CSVD发生发展的能力。采用ROC分析确定这些预测指标的最佳阈值、敏感性和特异性。
盐敏感性增加（截断值：8.5 mm/h；敏感性64%，特异性74%）和渗透脆性增加（截断值：0.62 u.a.；敏感性52%，特异性90%）或两者同时使用（模型<0.000001，截断值0.62；敏感性88%，特异性68%）是CSVD的独立预测指标。根据 Fazekas 分期，盐敏感性和渗透脆性增加也分别与白质高信号严重程度加快独立相关（分别为=0.019和0.004）。
根据盐敏感性和渗透脆性增加来预测CSVD的可能性使我们将它们视为CSVD的危险因素。为了识别CSVD的风险群体及其个体预防，有必要对这些用于临床实践的检测进行标准化。
