血清hs-CRP、HCY、CPI水平与卒中后认知障碍发生及预后的相关性研究

Research on Correlation between Serum hs-CRP, HCY, CPI Levels and Occurrence and Prognosis of Cognitive Disorder after Stroke

目的探讨急性缺血性脑卒中并发认知障碍与血清hs-CRP、HCY、CPI水平之间的关系。方法整群选取齐齐哈尔医学院附属第三医院2015年6—12月的急性缺血性脑卒中患者76例,应用MMSE及Mo CA进行认知能力评估,将病例分为卒中后认知障碍组(29例)与卒中后非认知障碍组(47例),选取30名健康体检人作为对照组。检测血清hs-CRP、HCY、CPI,分别分析MMSE及Mo CA与hs-CRP、HCY、CPI三者间的相关性。结果 (1)卒中后认知障碍组hsCRP、HCY及CPI为(20.83±3.41)mg/L、(27.53±3.07)μmol/L、(1.75±0.33)mg/L,卒中后非认知障碍组hs-CRP、HCY及CPI为(8.59±1.73)mg/L、(15.95±2.04)μmol/L、(1.41±0.18)mg/L,对照组hs-CRP、HCY及CPI为(2.61±0.87)mg/L、(8.65±1.54)μmol/L、(1.21±0.27)mg/L,卒中后认知障碍组血清hs-CRP、HCY及CPI均高于卒中后非认知障碍组、对照组,差异有统计学意义(P<0.05)。(2)卒中后认知障碍组的MMSE及Mo CA为(15.72±4.67)分、(16.03±4.82)分,卒中后非认知障碍组MMSE及Mo CA为(26.57±1.50)分、(27.13±1.29)分,卒中后认知障碍组的MMSE及Mo CA均高于卒中后非认知障碍组,差异有统计学意义(P<0.05)。(3)缺血性脑卒中后认知能力量表MMSE与hs-CRP呈负相关(r=-0.707,P<0.05),与HCY呈负相关(r=-0.665,P<0.05),与CPI呈负相关(r=-0.315,P<0.05)。缺血性脑卒中Mo CA与hs-CRP呈负相关(r=-0.612,P<0.05),与HCY呈负相关(r=-0.474,P<0.05),与CPI呈负相关(r=-0.280,P<0.05)。结论缺血性脑卒中后认知障碍的发生与hsCRP、HCY、CPI水平增高密切相关。

Objective To discuss the correlation between serum hs-CRP, HCY, CPI levels and occurrence and prognosis of cognitive disorder after stroke. Methods Group selection 76 cases of patients with acute ischemic stroke treated in our hospital from June 2015 to December 2016 were selected and the cognitive ability was evaluated by the MMSE and MoCA, and the patients were divided into the cognitive disorder group after stroke and non-cognitive disorder group after stroke,30 cases of healthy physical examination persons were selected as the control group, and the serum hs-CRP,HCY,CPI were tested and the correlation between MMSE, MoCA and hs-CRP,HCY,CPI were respectively analyzed. Results hs-CRP,HCY and CPI were respectively（20.83±3.41）mg/L,（27.53±3.07）μmo L/L,（1.75±0.33）mg/L in the cognitive disorder after stroke group（8.59±1.73）mg/L,（15.95±2.04）μmol/L,（1.41±0.18）mg/L in the non-cognitive disorder after stroke and（2.61±0.87）mg/L,（8.65±1.54）μmol/L,（1.21±0.27）mg/L in the control group, and the serum hs-CRP,HCY and CPI in the cognitive disorder after stoke group were higher than those in the control group, and the differences had statistical significance（P〈0.05）. The MMSE and MoCA in the cognitive disorder after stroke group was higher than that in the non-cognitive disorder group [（15.72 ±4.67）points,（16.03 ±4.82）points vs（26.57±1.50）points,（27.13±1.29）points], and the differences had statistical significance（P〈0.05）.The MMSE was negatively correlated with the hs-CRP（r=-0.707,P〈0.05）, HCY（r=-0.665,P〈0.05） and CPI（r=-0.315,P〈0.05）, and the MoCA was negatively correlated with the hs-CRP（r=-0.612,P〈0.05）, HCY（r=-0.474,P〈0.05） and CPI（r=-0.280,P〈0.05）. Conclusion The occurrence of cognitive disorder after cerebral arterial thrombosis is closely correlated with the increase of hs-CRP, HCY and CPI.