血清维生素及海马体积与卒中后认知障碍的相关性

Correlation of serum vitamin,hippocampal volume and cognitive domain in patients of post stroke cognitive impairment

目的 探讨卒中后认知障碍(PSCI)患者血清维生素水平、海马体积与认知域的相关性。方法纳入南京大学医学院附属鼓楼医院神经内科的55例脑卒中患者,其中认知正常(NC组)24例和PSCI(PSCI组)31例。检测血清维生素水平,采用认知量表评估认知域,高分辨磁共振评估海马体积。结果相对于NC组,PSCI组在语言、执行功能、注意力及视空间能力方面表现更差。PSCI组血清25-羟基维生素D[(33.77±13.41)μg/L]水平显著低于NC组[(61.47±20.89)μg/L],血清维生素B;[(9.18±4.85)μg/L]水平显著低于NC组[(17.18±4.53)μg/L],血清维生素B;[(10.16±4.87)μg/L]水平显著低于NC组[(20.17±8.67)μg/L],血清维生素B;2水平[(308.22±173.26)ng/L]显著低于NC组[(796.07±339.46)ng/L]。Pearson相关性分析提示,血清维生素B;水平与语言功能显著相关(r=0.426,P=0.001),血清维生素B;水平与记忆(r=0.331,P=0.014)、语言(r=0.326,P=0.007)、执行(r=—0.431,P=0.001)和视空间(r=0.291,P=0.031)功能显著相关,血清维生素B;2水平与记忆(r=0.326,P=0.015)、语言(r=0.398,P=0.003)和执行(r=—0.332,P=0.013)功能显著相关,左侧海马体积与记忆(r=0.288,P=0.033)和语言(r=0.296,P=0.028)功能显著相关。多元线性回归分析表明,左侧海马体积可能是记忆功能的预测指标(β=0.606,P=0.021),血清维生素B;水平可能是语言功能的预测指标(β=0.350,P=0.013),血清维生素B;水平可能是执行功能的预测指标(β=—0.379,P=0.025)。结论 PSCI患者左侧海马体积可能是记忆功能的预测指标,血清维生素B;水平可能是语言功能的预测指标,血清维生素B;水平可能是执行功能的预测指标。

Objective To investigate the correlation between serum vitamin,hippocampal volume and cognitive domain in patients with post stroke cognitive impairment(PSCI).Methods Fifty-five cases from the Department of Neurology,Affiliated Drum Tower Hospital of Nanjing University Medical School,including 24 cases were cognitively normal(NC group) and 31 cases were PSCI(PSCI group).Serum vitamin levels were detected.Neuropsychology was used to evaluate the cognitive domain and high resolution magnetic resonance was used to evaluate hippocampal volume.Results Compared with NC group,PSCI group performed worse in language,executive function,attention and visuospatial ability.The level of 25-hydroxyvitamin D in PSCI group((33.77±13.41) μg/L)was significantly lower than that in NC group((61.47±20.89) μg/L).The level of serum vitamin B;in PSCI group((9.18±4.85) μg/L) was significantly lower than that in NC group((17.18±4.53) μg/L).The level of serum vitamin B——6 in PSCI group((10.16±4.87) μg/L) was significantly lower than that in NC group((20.17±8.67)μg/L).The serum vitamin B;level in PSCI group((308.22±173.26) ng/L) was significantly lower than that in NC group((796.07±339.46) ng/L).Correlation analysis showed that serum vitamin B;level was significantly correlated with language function(r=0.426,P=0.001),serum vitamin B;level was significantly correlated with memory(r=0.331,P=0.014),language(r=0.326,P=0.007),executive(r=-0.431,P=0.001) and visuospatial ability(r=0.291,P=0.031),serum vitamin B;level was significantly correlated with memory(r=0.326,P=0.015),language(r=0.398,P=0.003) and executive function(r=-0.332,P=0.013),and left hippocampus volume was significantly correlated with memory(r=0.288,P=0.033) and language function(r=0.296,P=0.028).Multiple linear regression analysis suggested that left hippocampus volume may be a predictor of memory function(β=0.606,P=0.021),serum vitamin B;level may be a predictor of language function(β=0.350,P=0.013),and serum vitamin Bs level may be a predictor of executive function(β=-0.379,P=0.025).Conclusion In PSCI patients,left hippocampus volume may be a predictor of memory function,serum vitamin B;level may be a predictor of language function,and serum vitamin B;level may be a predictor of executive function.