血尿酸与脑小血管病患者血管性轻度认知障碍的相关性研究

Correlation between Serum Uric Acid and Vascular Mild Cognitive Impairment in Patients with Cerebral Small Vessel Disease

目的探讨血尿酸(uricacid,UA)与脑小血管病(cerebral small vessel disease,CSVD)患者血管性轻度认知障碍(vascular mild cognitive impairment,VaMCI)的相关性。方法选择2015年10月-2017年6月于潍坊医学院附属医院就诊的87例CSVD患者和44例体检者,根据蒙特利尔评估表(montreal cognitive assessment,MoCA)将CSVD患者分为VaMCI组47例和认知正常组40例,用Logistic回归分析及Pearson相关分析来分析尿酸与脑小血管病患者轻度认知障碍的相关性。结果 CSVD认知正常组及轻度认知障碍组血UA水平[(315.15±56.76)μmol/L,(363.32±42.58)μmol/L]高于对照组[(269.66±40.21)μmol/L](均P<0.001),且CSVD轻度认知障碍组血尿酸水平高于认知正常组(P<0.001)。轻度认知损害组UA水平与其MoCA总分、视空间与执行能力、记忆、语言呈负相关(r=-0.351,P=0.015;r=-0.456,P=0.001;r=-0.408,P=0.004;r=-0.329,P=0.024)。Logistic回归分析结果显示,血UA水平[比值比(odds ratio,OR)1.020,95%可信区间(confidence interval,CI)1.009～1.032,P=0.01]是CSVD患者轻度认知障碍的独立危险因素。结论 CSVD血管性轻度认知障碍患者血UA升高,且血UA是CSVD患者轻度认知障碍的危险因素。UA水平与CSVD血管性轻度认知障碍患者蒙特利尔评估总分、视空间与执行能力、记忆、语言呈负相关。

Objective To investigate the correlation between serum uricacid（UA） and vascular mild cognitive impairment（VaMCI） in patients with cerebral small vessel disease（CSVD）.Methods Between October 2015 and June 2017, 87 patients with CSVD and 44 healthy individuals were enrolled from department of neurology of the affiliated hospital of weifang medical university. According to the Montreal cognitive assessment（MoCA） scale, the patients with CSVD were divided into the VaMCI group（n =47） and normal cognition group（n =40）. The association between serum UA and VaMCI in patients with CSVD was analyzed by Logistic regression analysis and Pearson correlation analysis.Results Compared with the control group [（269.66±40.21） μmol/L], serum UA levels in the normal cognition and VaMCI groups [（315.15±56.76） μmol/L,（363.32±42.58） μmol/L] were increased（all P 〈0.001）. Serum UA level was higher in the VaMCI group than that in the normal cognition group（P〈0.001）. Serum UA level was negatively correlated with MoCA total score, subscores on visuospatial ability and executive function, recall, and language ability（r =-0.351, P =0.015; r =-0.456, P=0.001; r=-0.408, P=0.004, r=-0.329, P=0.024）. Logistic regression analysis showed that serum UA level [odds ratio（OR） 1.020, 95% confidence interval（CI） 1.009-1.032, P=0.01） was independent risk factor of vascular mild cognitive impairment in patients with CSVD.Conclusion Serum UA level was significantly increased in the VaMCI group, and UA level mightbe a risk factor of VaMCI in patients with CSVD. Serum UA level was negatively correlated with MoCA total score, subscores on visuospatial ability and executive function, recall, and language ability.