平均血小板体积与脑白质疏松症患者认知功能下降的相关性

Correlation between mean platelet volume and cognitive decline in patients with leukoaraiosis

目的探讨平均血小板体积(MPV)与脑白质疏松症(LA)的发生及认知功能下降是否存在相关性。方法纳入2014年1月至2016年4月于华北理工大学附属门诊及住院的192例LA患者为LA组和108例磁共振成像正常者为无LA组,并收集其人口学资料。采用蒙特利尔认知评估量表(Mo CA)分析LA组与无LA组认知功能的差异。患者在入院即刻或次日晨起查血常规,分析LA相关认知功能障碍与MPV相关性。结果 LA组患者较正常对照组MPV水平无统计学差异[(10.20±1.77)fl vs(10.2±0.96)fl,P>0.05]。线性相关分析显示,LA患者MPV水平与不同认知功能(视空间执行能力、命名、注意力、语言、抽象、延迟记忆、定向等)之间均不存在相关性(P>0.05)。分层分析显示,当年龄<51岁时,LA组MPV水平高于无LA组,差异有统计学意义[(10.36±1.31)fl vs(8.22±1.20)fl,P<0.05]。Logistic回归分析显示,Mo CA评分是LA发生的独立有益因素(OR=0.781,P=0.028);当年龄<51岁时,MPV升高是LA发生的独立危险因素(OR=1.067,P=0.017)。结论当年龄<51岁时,MPV升高,则LA发生的危险性增高。

Objective To investigate the association of mean platelet volume （MPV） with leukoaraiosis （LA） and cognitive function decline. Methods A total of 192 LA patients and 108 normal controls by magnetic resonance imaging （MRI） were included in the Hospital Affiliated to North China University of Science and Technology from January 2014 to April 2016, and the demographic data were collected also. The cognitive function was measured by Montreal cognitive assessment scale （MoCA） in LA group and control group. Blood routine examination was performed immediately after admission or at the next morning after admission, and the correlation between LA- related cognitive impairment and MPV was analyzed. Results There was no significant difference in MPV level between LA group and control group [ （ 10. 20 ± 1.77 ） fl vs （ 10. 2 ± 0. 96 ） fl, P 〉 0. 05 ]. Linear correlation analysis showed that there was no correlation between the level of MPV and different cognitive functions （visual spatial execution, naming, attention, language, abstract, delayed memory, orientation, etc. ）in LA patients （all P 〉 0. 05 ）. Stratified analysis showed that when age was less than 51 years old, MPV level in LA group was significant higher than that in control group[ （ 10. 36 ± 1.31 ）fl vs（8.22 ＋ 1.20）fl,P 〈 0. 05 ]. Logistic regression analysis showed that MoCA score was an independent beneficial factor for incidence of LA （ OR =0. 781 ,P =0. 028）, and when age was less than 51 years old, MPV was an independent risk factor for incidence of LA（ OR = 1. 067 ,P =0. 017）. Conclusion There is a correlation between the increase of MPV value and the occurrence of LA when the patients＇ age is less than 51 years old.