涂层血小板水平与急性脑梗死患者认知水平的相关性

Correlation between coated plateletlevel and cognitive level in patients with acute cerebral infraction

目的探索急性脑梗死(ACI)患者其涂层血小板水平与认知水平相关性。方法纳入2018年1月-2019年9月于辽宁省人民医院神经内科治疗的ACI患者167例,收集所有患者年龄、性别、吸烟、糖尿病、高血压、高脂血症等基本临床资料,收集所有患者血小板计数、涂层血小板、白细胞、血红蛋白、C反应蛋白(C reactive protein,CRP)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)等实验室指标。随访至出院后3个月,采用简易智力状态检查量表(Mini-mental State Examination,MMSE)评分量表评估所有患者认知功能障碍情况,根据评分结果将其分为认知无异常组及认知障碍组,应用Pearson相关模型分析ACI患者涂层血小板水平与认知水平的相关性,多因素Logistic回归模型分析ACI患者发生认知障碍的危险因素。结果纳入的167例ACI患者中,失访11例,其余156例患者中有74例患者发生认知功能障碍,发生率为47.43%。ACI患者涂层血小板水平与MMSE评分存在明显负相关(r=-0.731,P<0.001)。高血压(OR=12.946,P=0.000),高血脂(OR=5.576,P=0.005),病灶位于枕叶丘脑(OR=11.214,P=0.003),NIHSS评分(OR=1.314,P=0.002),涂层血小板(OR=1.193,P=0.000),CRP(OR=2.015,P=0.003),NSE(OR=1.285,P=0.004)是ACI后认知障碍的危险因素;脑梗死单发病灶(OR=0.097,P=0.000)是脑梗死后认知障碍的保护因素。结论高水平涂层血小板将增加ACI后认知障碍的风险,在早期可以将其作为ACI后认知障碍的预测因子。

Objective To explore the correlation between coated platelet level and cognitive level in patients with acute cerebral infarction(ACI).Methods A total of 167 patients with ACI treated in our hospital from January 2018 to September 2019 were collected.Basic clinical data such as age,sex,smoking,diabetes,hypertension,hyperlipidemia,platelet count,coated laboratory platelets,white blood cells,hemoglobin,C reactive protein(CRP),neuron-specific enolase(NSE)and other laboratory indicators.Outpatient follow-up for 3 months after discharge,Minimental State Examination(MMSE)score scale was used to assess thecognitive impairment of all patients.According to the scoring results,they are divided into cognitive no abnormality group and cognitive impairment group.Correlation between coated platelet level and cognitive level in patients with ACI using Pearson correlation model,Multivariate Logistic regression model was used to analyze the risk factors of cognitive impairment in patients with acute cerebral infarction.Results Among the 167 included patients with ACI,11 lost to follow-up,and 74 of the remaining 156 patients developed cognitive dysfunction,with an incidence of 47.43%.There was a significant negative correlation between the levels of coated platelets and MMSE scores in patients ACI(r=-0.731,P<0.001).Hypertension(OR=12.946,P=0.000),hyperlipidemia(OR=5.576,P=0.005),lesions located in the occipital thalamus(OR=11.214,P=0.003),NIHSS score(OR=1.314,P=0.002)Coated platelets(OR=1.193,P=0.000),CRP(OR=2.015,P=0.003),NSE(OR=1.285,P=0.004)are risk factors for cognitive impairment after ACI;Cerebral infarction single lesion(OR=0.097,P=0.000)is the protective factor for cognitive impairment after cerebral infarction.Conclusion High-level coated platelets will increase the risk of cognitive impairment after cerebral infarction,and it can be used as a predictor of cognitive impairment after cerebral infarction at an early stage.