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非致残性缺血性脑血管事件患者外周炎症和脂质参数、脑白质高信号与认知功能的相关性。

The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events.

机构信息

Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.

出版信息

BMC Neurol. 2024 Mar 4;24(1):86. doi: 10.1186/s12883-024-03591-6.

Abstract

BACKGROUND

The global prevalence of VCI has increased steadily in recent years, but diagnostic biomarkers for VCI in patients with non-disabling ischemic cerebrovascular incidents (NICE) remain indefinite. The primary objective of this research was to investigate the relationship between peripheral serological markers, white matter damage, and cognitive function in individuals with NICE.

METHODS

We collected clinical data, demographic information, and medical history from 257 patients with NICE. Using the MoCA upon admission, patients were categorized into either normal cognitive function (NCF) or VCI groups. Furthermore, they were classified as having mild white matter hyperintensity (mWMH) or severe WMH based on Fazekas scores. We then compared the levels of serological markers between the cognitive function groups and the WMH groups.

RESULTS

Among 257 patients with NICE, 165 were male and 92 were female. Lymphocyte count (OR = 0.448, P < 0.001) and LDL-C/HDL-C (OR = 0.725, P = 0.028) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age and inflammation markers but a lower MoCA score, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.765, P < 0.001) and LDL-C/HDL-C (AUC = 0.740, P < 0.001) had an acceptable diagnostic value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups.

CONCLUSION

Lymphocyte count, LDL-C/HDL-C were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.

摘要

背景

近年来,全球血管性认知障碍(VCI)的患病率稳步上升,但非致残性缺血性脑血管事件(NICE)患者的 VCI 诊断生物标志物仍不明确。本研究的主要目的是探讨 NICE 患者外周血血清标志物与脑白质损伤及认知功能的关系。

方法

收集 257 例 NICE 患者的临床资料、人口学资料及既往史。根据入院时 MoCA 评分,将患者分为认知功能正常(NCF)组和 VCI 组。根据 Fazekas 评分,将患者分为轻度脑白质高信号(mWMH)组和重度脑白质高信号(sWMH)组。比较两组患者血清标志物水平。

结果

257 例 NICE 患者中,男 165 例,女 92 例。淋巴细胞计数(OR=0.448,P<0.001)和 LDL-C/HDL-C(OR=0.725,P=0.028)是 NICE 患者认知功能的保护因素。sWMH 组年龄、炎症标志物高于 mWMH 组,MoCA 评分、淋巴细胞计数低于 mWMH 组。在 mWMH 组中,淋巴细胞计数(AUC=0.765,P<0.001)和 LDL-C/HDL-C(AUC=0.740,P<0.001)对 VCI 具有较好的诊断价值。在 sWMH 组中,NCF 组与 VCI 组间血清标志物差异无统计学意义。

结论

淋巴细胞计数、LDL-C/HDL-C 是 NICE 患者认知功能的独立保护因素;可作为潜在的生物学标志物,用于鉴别 NICE 患者的 VCI,适用于 mWMH 亚组患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2774/10910845/f7366e5f4f8b/12883_2024_3591_Fig1_HTML.jpg

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