The Clinical Laboratory of Bozhou People's Hospital, BoZhou 236800, China.
Clin Neurol Neurosurg. 2024 Oct;245:108503. doi: 10.1016/j.clineuro.2024.108503. Epub 2024 Aug 8.
Cerebral infarction treatments are most effective if used early after stroke symptoms occur. Also, early detection is crucial for delaying and improving cognitive impairment. This study investigated the relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (Non-HDL-C/HDL-C), which reflects the entire burden of the cholesterol transported in atherogenic lipoproteins, and the level of β-amyloid 1-42 (Aβ-1-42), a major component of cerebrovascular amyloid deposits, in peripheral blood and cognitive dysfunction secondary to cerebral infarction.
A total of 83 patients with cerebral infarction admitted to Bozhou People's Hospital between June 2019 and June 2022 were assessed. The patients were divided into two groups based on their Mini-Mental State Scale (MMSE) scores: cognitive dysfunction group (n = 30) and non-cognitive dysfunction group (n = 53). In addition, a control group comprising 34 patients with transient cerebral insufficiency or cerebrovascular stenosis was selected. The groups were compared in terms of various clinical factors, including gender, age, hypertension, hyperlipidemia, lipid indexes, Non-HDL-C/HDL-C, and Aβ1-42 levels. Logistic regression analysis was used to identify the risk factors associated with cognitive dysfunction.
The results showed that hypertensive patients with cognitive dysfunction secondary to cerebral infarction had a higher proportion of frontal lobe, temporal lobe, and thalamus involvement and lower scores on the MMSE compared to the non-cognitive impairment group and control group (p < 0.05). Additionally, the levels of homocysteine (HCY), Non-HDL-C/HDL-C, and Aβ1-42 in peripheral blood were significantly higher in hypertensive patients with cognitive dysfunction compared to the other two groups (all p < 0.05) and were identified as risk factors for cognitive dysfunction secondary to cerebral infarction. Peripheral blood levels of Non-HDL-C/HDL-C and Aβ1-42 are risk factors for secondary cognitive dysfunction following a cerebral infarction.
These data have important clinical implications for understanding the mechanisms underlying cognitive dysfunction in individuals with cerebrovascular disorders, potentially leading to new early interventions for preventing or treating such diseases.
脑梗死治疗在中风症状发生后尽早进行最为有效。此外,早期发现对于延缓和改善认知障碍至关重要。本研究旨在探讨外周血中非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(Non-HDL-C/HDL-C)与脑梗死继发认知功能障碍之间的关系,Non-HDL-C/HDL-C 反映了致动脉粥样硬化脂蛋白中胆固醇的整体负荷,β-淀粉样蛋白 1-42(Aβ-1-42)是脑血管淀粉样沉积物的主要成分。
选取 2019 年 6 月至 2022 年 6 月在我院住院的 83 例脑梗死患者进行评估。根据简易智力状态检查量表(MMSE)评分,将患者分为认知功能障碍组(n=30)和非认知功能障碍组(n=53)。此外,还选择了 34 例短暂性脑缺血发作或脑血管狭窄患者作为对照组。比较了各组之间的性别、年龄、高血压、高血脂、血脂指标、Non-HDL-C/HDL-C 和 Aβ1-42 水平等各项临床因素。采用 Logistic 回归分析确定与认知功能障碍相关的危险因素。
结果显示,脑梗死继发认知功能障碍的高血压患者,额叶、颞叶和丘脑受累比例较高,MMSE 评分较低,与非认知损害组和对照组相比差异有统计学意义(p<0.05)。此外,高血压伴认知功能障碍患者的外周血同型半胱氨酸(HCY)、Non-HDL-C/HDL-C 和 Aβ1-42 水平明显高于其他两组(均 p<0.05),是脑梗死继发认知功能障碍的危险因素。外周血 Non-HDL-C/HDL-C 和 Aβ1-42 水平是脑梗死继发认知功能障碍的危险因素。
这些数据对于理解脑血管疾病患者认知功能障碍的机制具有重要的临床意义,可能为预防或治疗此类疾病提供新的早期干预措施。