脑梗死患者认知功能障碍与高半胱氨酸及类胰岛素样生长因子-1的相关性分析

Correlation between total homocysteine,insulin-like growth factor-1 and mild cognitive impairment after stroke

目的探讨脑梗死患者认知功能障碍与高半胱氨酸(t Hcy)及类胰岛素样生长因子-1(IGF-1)的相关性。方法选取我院98例脑梗死患者及同期45例健康体检者作为观察对象,比较脑梗死组与健康体检组血清t Hcy、IGF-1浓度。根据蒙特利尔认知评估量表(Mo CA)评分结果将脑梗死患者分为认知功能障碍组42例和认知功能正常组56例,比较两组患者血清t Hcy、IGF-1浓度。以t Hcy、IGF-1作为脑梗死后认知功能障碍的潜在危险因素,进行Logistic多因素回归分析。结果脑梗死组血清t Hcy浓度显著高于健康体检组,血清IGF-1浓度显著低于健康体检组(P<0.05)。认知功能障碍组血清t Hcy浓度显著高于认知功能正常组,血清IGF-1浓度显著低于认知功能正常组(P<0.05)。高血清t Hcy浓度、低血清IGF-1浓度为脑梗死后认知功能障碍的独立危险因素。结论脑梗死患者存在高水平的血清t Hcy及低水平的血清IGF-1,脑梗死后认知功能障碍的发生与t Hcy、IGF-1密切相关,高血清t Hcy浓度、低血清IGF-1浓度可显著增大脑梗死后并发认知功能障碍的风险。

Objective To investigate the con＇elation between total homocysteine （tHcy） ,insulin-like growth factor-1 （IGF-1） and mild cognitive impairment in stroke patients. Methods Ninety-eight stoke patients and 45 healthy people were selected as subjects for this study. The serum levels of tHcy and IGF-1 were measured. According to the MoCA scores,the stroke patients were divided into cognitive impairment group （ n = 42 ） and the cognitive normal group （ n = 56 ）. Serum levels of tHcy and IGF-1 levels were compared between the two groups. Logistic analysis of multi-factor regression was used to evaluate the relationship of tHcy and IGF-1 with mild cognitive impairment after stroke. Results The serum level of tHcy was higher and the IGF-1 level was lower in the stroke patients than those in the controls （ P 〈 0.05 ）. The tHcy level was higher and IGF-1 level was lower in the cognitive impairment group than those in the cognitive normal group, while the than that in cognitive normal group （ P 〈 0. 05 ）. Logistic analysis of multi-factor regression showed that the high tHcy level and low IGF-1 level were independent risk factors for mild cognitive impairment after stroke. Conclusion There is high tHcy level and low IGF-1 level in stroke patients. The mild cognitive impairment after stroke is related with tHcy and IGF-1 levels. The high tHcy level and low IGF-1 level might be risk factors for mild cognitive impairment after stroke.