老年脑梗死后认知功能障碍患者血清OC、ACA、Klotho蛋白变化及预后相关性

Serum OC,ACA,Klotho Protein Changes and Prognostic Correlation in Elderly Patients With Cognitive Dysfunction After Cerebral Infarction

目的探讨老年脑梗死后认知功能障碍骨钙素(osteocalcin,OC)、抗心磷脂抗体(anti cardiolipin antibody,ACA)、Klotho蛋白水平变化及与预后相关性,以期为临床评估认知功能障碍、早期预测预后提供参考。方法选取泉州市第一医院2020年8月—2022年8月就诊的老年脑梗死患者200例作为研究对象,根据有无认知功能障碍分为认知功能障碍组(n=68)与非认知功能障碍组(n=132)。比较两组血清OC、ACA、Klotho蛋白水平及蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,并进行相关性分析;随访6个月,比较不同预后患者血清OC、ACA、Klotho蛋白水平,分析其对老年脑梗死预后评估价值。结果与非认知功能障碍组比较,认知功能障碍组血清OC、Klotho、Mo CA评分较低,血清ACA水平较高(P<0.05)。血清OC、Klotho与老年脑梗死患者MoCA评分呈正相关,血清ACA与MoCA评分呈负相关(P<0.05)。与预后良好患者比较,预后不良患者血清OC、Klotho水平较低,血清ACA水平较高(P<0.05)。血清OC、ACA、Klotho预测老年脑梗死患者预后不良的AUC分别为0.832、0.795、0.856,各指标联合预测AUC为0.927,高于单一指标预测。结论血清OC、Klotho、ACA与老年脑梗死患者认知功能障碍显著相关,临床可通过其水平变化初步预测患者预后,以针对性展开后续治疗、改善预后。

Objective To investigate the changes of osteocalcin(OC),anti cardiolipin antibody(ACA)and Klotho protein levels in elderly patients with cognitive dysfunction after cerebral infarction and their correlation with prognosis.In order to provide reference for clinical assessment of cognitive dysfunction and early prognosis.Methods A total of 200 elderly cerebral infarction patients of Quanzhou First Hospital from August 2020 to August 2022 were selected as research objects,and were divided into cognitive dysfunction group(n=68)and non-cognitive dysfunction group(n=132)according to whether they had cognitive dysfunction.Serum OC,ACA,Klotho protein levels and Montreal cognitive assessment(MoCA)scores were compared between the two groups,and correlation analysis was conducted.After 6 months of follow-up,serum OC,ACA,Klotho protein levels of patients with different prognosis were compared and its prognostic value for senile cerebral infarction was compared.Results Compared with the non-cognitive dysfunction group,the serum OC,Klotho and MoCA scores in the cognitive dysfunction group were lower,and the serum ACA level was higher(P<0.05).Serum OC,Klotho and elderly patients with cerebral infarction were positively correlated with MoCA score,while serum ACA and MoCA score were negatively correlated(P<0.05).Compared with patients with good prognosis,patients with poor prognosis had lower serum OC and Klotho levels and higher serum ACA levels(P<0.05).The AUC of serum OC,ACA and Klotho in predicting poor prognosis in elderly patients with cerebral infarction was 0.832,0.795 and 0.856,respectively,and the AUC of combined prediction was 0.927,which was higher than that of single prediction.Conclusion Serum OC,Klotho and ACA are significantly correlated with cognitive dysfunction in elderly patients with cerebral infarction.The prognosis of patients can be preliminarily predicted by the changes in their levels,so as to carry out targeted follow-up treatment and improve the prognosis.