血浆纤维蛋白原水平与脑梗死后认知功能障碍相关性研究

Relationship between the level of plasma fibrinogen and cognitive impairment in patients after cerebral infarction

目的 探讨血浆纤维蛋白原水平及相关因素对脑梗死患者认知功能状态的影响.方法 采用韦氏记忆测试量表,对急性脑梗死3个月左右[（90±15）d]的280例患者进行神经心理学测试,确诊认知功能障碍32例.通过匹配年龄、性别及脑梗死部位及大小,选择同时期认知功能正常的脑梗死患者32例作为对照组.检测血浆纤维蛋白原水平及相关的可能危险因素,比较两组差异,分析影响脑梗死患者认知功能障碍的独立危险因素.结果 认知功能障碍组与对照组危险因素比较,高血压持续时间、血浆纤维蛋白原、胆固醇、血糖、叶酸等水平的差异有统计学意义（P＜0.05）.剔除高血压持续时间、总胆固醇等因素,血浆纤维蛋白原水平仍是脑梗死后患者认知功能障碍的危险因素[Exp（B）＝41.049,95%CI为6.355-265.136,P＝0.000].结论 血浆纤维蛋白原水平升高可能是导致急性脑梗死后患者认知功能障碍的独立危险因素.

Objective To investigate the association of plasma fibrinogen level with cognitive impairment in patients after cerebral infarction. Methods Total 280 patients with cerebral infarction were enrolled in the study, among them 32 were diagnosed as cognitive impairment by Webster memory test, other 32 matched patients, who had no cognitive dysfunction, were selected as controls. The level of plasma fibrinogen and other parameters were examined in both groups, and the risk factors of cognitive impairment in patients with cerebral infarction were analyzed. Results Significant differences existed between two groups in the persistence time of hypertension, plasma levels of cholesterol, fibrinogen, glucose and folic acid （P〈0.05）. Binary logistic regression demonstrated that statistical difference still existed between two groups in plasma levels of fibrinogen [Exp（ B ） =1.684,95% CI 1.304-2.179,P = 0.005]. Conclusion Plasma fibrinogen level is independently associated with cognitive impairment after cerebral infarction, and it might be used for screening of cognitive impairment in stroke patients.