D-二聚体、尿酸联合补体C3、C4水平对老年抑郁症患者认知损害的预测价值

Predictive value of D-dimer,uric acid combined with complement C3 and C4 levels on cognitive impairment in elderly patients with depression

目的分析D-二聚体、尿酸(UA)联合补体C3、C4水平对老年抑郁症(LLD)患者认知损害(MCI)的预测价值。方法选取2018年4月至2021年3月于江苏淮安市第三人民医院精神科就诊的LLD患者96例作为研究对象,检测患者D-二聚体、UA和补体C3、C4水平,随访1年,根据是否伴有MCI,将患者分为MCI组(n=51)和非MCI组(n=45)。对两组患者临床资料及D-二聚体、UA和补体C3、C4水平进行比较,采用多因素logistic回归分析筛选LLD患者MCI分独立危险因素,绘制受试者工作特性曲线(ROC)分析D-二聚体、UA联合补体C3、C4水平对LLC患者MCI的预测效能。结果MCI组独居患者比例、D-二聚体、UA水平高于非MCI组,受教育年限、睡眠时长、MMSE评分、补体C3、C4水平均低于非MCI组,差异具有统计学意义(χ^(2)=7.218、t=2.354、2.112、2.573、2.653、8.176、3.188、2.641,P<0.05);多因素Logistics回归结果显示受教育年限和D-二聚体、UA、补体C3、C4水平为LLD患者发生MCI独立影响因素(P<0.05);ROC曲线结果显示,D-二聚体、UA和补体C3、C4水平及4项指标联合曲线下面积(AUC)分别为0.663、0.834、0.672、0.678、0.904,敏感度分别为0.711、0.778、0.759、0.533、0.733,特异性分别为0.706、0.765、0.569、0.824、0.902(P<0.05)。结论D-二聚体、UA和补体C3、C4与LLD患者发生MCI存在密切关系,D-二聚体、尿酸联合补体C3、C4水平对LLD患者MCI具有良好的预测价值。

Objective To analyze the predictive value of D-dimer,uric acid(UA)combined with complement C3 and C4 levels on cognitive impairment(MCI)in elderly patients with major depressive disorder(LLD).Methods A total of 96 patients with LLD treated in the Department of Psychiatry,The Third People’s Hospital of Huai’an,Jiangsu from April 2018 to March 2021 were selected as the research objects.And D-dimer,UA and complement C3 and C4 levels were measured and followed for 1 year,and the patients were divided into MCI(n=51)and non MCI(n=45)groups according to whether they had MCI or not.Clinical data and levels of D-dimer,UA and complement C3 and C4 were compared between the two groups,independent risk factors for MCI in LLC patients were screened by multivariate logistic regression analysis,and receiver operating characteristic curve(ROC)were drawn to analyze the predictive efficacy of D-dimer,UA combined with complement C3and C4 levels for MCI in LLC patients.Results The proportion of patients living alone,D-dimer,and UA levels in the MCI group were higher than those in the non MCI group,and the years of education,sleep duration,MMSE scores,and complement C3 and C4 levels were lower than those in in the non MCI group,with significant differences(χ^(2)=7.218,t=2.354,2.112,2.573,2.653,8.176,3.188,2.641,P<0.05).Multivariate logistic regression results showed that the years of education and levels of D-dimer,UA,complement C3 and C4 were independent influencing factors(P<0.05)for the occurrence of MCI in LLD patients.The results of ROC curve showed that the area under the joint curve(AUC)of D-dimer,UA and complement C3 and C4 levels and four indicators were 0.663,0.834,0.672,0.678,0.904,respectively,with the sensitivities of 0.711,0.778,0.759,0.533,0.733,and the specificities of 0.706,0.765,0.569,0.824,0.902,respectively(P<0.05).Conclusion D-dimer,UA and complement C3 and C4 are closely related to the occurrence of MCI in LLD patients.The levels of D-dimer,uric acid combined with complement C3 and C4 have good predictive value for MCI in LLD patients.