脑小血管病合并心房颤动患者CRP D-二聚体水平与认知障碍的相关性研究

Application CRP and D-Dimer to assess the level of cognitive impairment in patients of atrial fibrillation combined with cerebral small vessel disease(CSVD)

目的探讨脑小血管病合并心房颤动患者C反应蛋白(CRP)、D-二聚体水平与认知障碍的相关性。方法选取房颤脑小血管病变患者95例,依据认知功能程度不同分为3组。收集3组患者的基本资料,测定血清甘油三酯、总胆固醇、空腹血糖、CRP、D-二聚体水平。结果 3组患者一般情况、血清甘油三酯、总胆固醇、空腹血糖比较,差异无统计学意义(P>0.05)。3组患者认知功能MOCA评分、ADL评分比较,VD组<VCI组<WVCI组。3组患者CRP、D二聚体比较,VD组与VCI组均明显高于WVCI组,差异有统计学意义(P<0.05);而VD组与VCI组比较,差异无统计学意义(P>0.05)。3组患者CRP+D二聚体升高率比较,VD组与VCI组均明显高于WVCI组,且VD组高于VCI组,差异有统计学意义(P<0.05)。认知损伤组(VD组+VCI组)CRP、D-二聚体水平与MOCA评分呈负相关(r=-0.584,-0.46,P<0.05)。结论房颤脑小血管病变患者的C反应蛋白与D-二聚体随认知障碍程度加重而逐渐升高,可作为早期认知功能障碍的筛查指标。

Objective To explore the relationship of CRP,D-Dimer with cognitive impairment in patients of atrial fibrillation combined with CSVD.Methods According to the level of cognitive impairment,95 patients of atrial fibrillation combined with SCVD were divided into three groups.We collected the baseline data.We measured the CRP,D-Dimer,triglyceride,total cholesterol and fasting blood glucose.Results There was no significant differences in the basic data,triglyceride,total cholesterol and fasting blood-glucose(P>0.05).Compare the score of MOCA and ADL,the VD group<VCI group<WVCI group.The VD group and the VCI group had a significantly higher than the WVCI group in the level of CRP,D-Dimer(P<0.05),but there was no significant differences between the VD group and the VCI group(P>0.05).In the increased percentage of CRP and D-Dimer,the VD group was significantly higher than the VCI group(P<0.05),while the VCI group was significantly higher than the WVCI group(P<0.05).CRP and D-Dimer were negatively correlated with cognitive function(r=-0.584,-0.46,P<0.05)in the VD group with VCI group.Conclusion In patients of atrial fibrillation combined with CSVD,the CRP and D-Dimer increased with cognitive impairment,the detection of CRP and D-Dimer can predict the level of cognitive impairment.