血清淀粉样蛋白A与脑梗死急性期认知功能的相关性

Correlation between serum amyloid A and cognitive function of patients with acute cerebral infarction

目的探讨人血清淀粉样蛋白A(SAA)与脑梗死急性期认知功能的关系。方法选择山东大学附属省立医院神经内科确诊的脑梗死急性期患者105例,采用简易精神状态检查(MMSE)评估患者认知功能。根据受教育年限不同,将患者分为受教育年数<6年组(n=36)和受教育年数≥6年组(n=69)。分析SAA与各个影响因素的相关性,包括年龄、性别、受教育程度、α2-巨球蛋白(α2-MG)、吸烟和其他脑血管疾病危险因素,以及与M M SE中各个认知领域的相关性。结果受教育年限<6年组患者M M SE评分以及时间和地点定向、短时记忆和图形执行力等认知域评分显著低于受教育年限≥6年组(P<0.05或P<0.01)。认知评估中,时间与地点定向评分在前循环梗死组(n=53)、后循环梗死组(n=44)和全循环梗死组(n=8)之间的分布差异有统计学意义(P<0.05)。Spearman相关性分析表明,SAA与α2-M G水平呈明显正相关(r=0.29,P<0.01);广义线性回归分析显示,SAA与时间和地点定向以及计算能力下降相关(P<0.05或P<0.01)。结论血清SAA水平升高与脑梗死急性期认知功能障碍有关,尤其是时间与地点定向和计算力障碍。

Objective To explore the relationship between human serum amyloid A（ SAA） and cognitive function of patients with acute cerebral infarction. Methods A total of 105 patients with acute cerebral infarction diagnosed in Department of Neurology of Shandong Provincial Hospital were selected and their cognitive functions were assessed by mini-mental state examination（ MMSE）. According to different education time,the patients were divided into two groups,education time 6 years group（ n = 36） and ≥6 years group（ n = 69）. Correlations between SAA and each influencing factor,including age,gender,education level,smoking and other cerebrovascular risk factors,as well as SAA and each cognitive domain in MMSE were analyzed. Results The scores of MMSE,time and place orientation,short-term memory and graphic execution in education time 6 years group were all significantly lower than those in education time ≥6 years group（ P〈0. 05 or P〈0. 01）. In cognitive assessment,the differences in the scores of time and place orientation were statistically significant among the patients with infarctions of anterior circulation（ n = 53）,posterior circulation（ n = 44）,or anterior and posterior circulation（ n = 8）（ P〈0. 05）. Spearman correlation analysis revealed that SAA was positively correlated with α2-MG（ r = 0. 29,P〈0. 01）. Generalized liner regression analysisdisplayed that SAA was related to the decreases of time and place orientation as well as computing capability（ P〈0. 05 or P〈0. 01）. Conclusion The increasing level of serum SAA is associated with cognitive impairment of patients with acute cerebral infarction,especially disturbance of time and place orientation as well as computing capability.