脑小血管病认知障碍患者Hcy、hs-CRP、PLR水平变化及其临床意义

Changes and clinical significance of levels of Hcy,hs-CRP and PLR in patients with cerebral small vessel disease complicated by cognitive dysfunction

目的探讨脑小血管病(CSVD)认知障碍患者同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、血小板与淋巴细胞比值(PLR)水平变化情况及其临床意义。方法抽取2020年1月至2022年12月平顶山市第一人民医院收治的182例CSVD患者,根据蒙特利尔认知量表(MoCA)评分进行分组,MoCA评分<26分的100例认知功能障碍患者纳入研究组,MoCA评分≥26分的82例无认知功能障碍患者纳入对照组。比较两组Hcy、hs-CRP、PLR等指标变化,分析其与脑小血管患者出现认知障碍的相关性。结果研究组血Hcy、hs-CRP、PLR水平均高于对照组,高密度脂蛋白水平低于对照组(P<0.05)。研究组腔隙性脑梗死数量及脑白质病变评分均高于对照组(P均<0.05)。经Logistic回归分析结果显示,血Hcy、hs-CRP、PLR是CSVD患者出现认知功能障碍的独立危险因素(P<0.05)。受试者工作特征曲线结果显示,Hcy、hs-CRP、PLR单独及联合检测预测CSVD患者出现认知功能障碍的曲线下面积分别为0.811、0.886,0.881、0.955。结论联合检测血Hcy、hs-CRP、PLR对预测CSVD患者出现认知功能障碍有较高的应用价值。

Objective To investigate the changes and clinical significance of levels of homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)and platelet lymphocyte rate(PLR)in patients with cerebral small vessel disease(CSVD)complicated by cognitive dysfunction.Methods One hundred and eighty-two patients with CSVD treated in Pingdingshan First People’s Hospital from January 2020 to December 2022 were selected.The selected patients were grouped by the Montreal cognitive scale(MoCA)score;100 patients with cognitive dysfunction with a MoCA score of<26 were included in the study group,while 82 patients without cognitive dysfunction with a MoCA score of≥26 were included in the control group.The changes in levels of Hcy,hs-CRP and PLR were compared between the two groups,and the correlation between these indicators and cognitive dysfunction were analyzed.Results The levels of Hcy,hs CRP and PLR in the study group were significantly higher than those in the control group,while high-density lipoprotein level was lower than that in the control group(P<0.05).The number of lacunar infarctions and cerebral white matter lesion score in the study group were significantly higher than those in the control group(all P<0.05).The results of logistic regression analysis showed that levels of Hcy,hs-CRP and PLR were independent risk factors for the development of cognitive dysfunction in CSVD patients(P<0.05).The results of receiver operating characteristic curve showed that the areas under the curve of Hcy,hs-CRP,PLR and combination of the three indicators in predicting cognitive dysfunction in CSVD patients were 0.811,0.886,0.881 and 0.955,respectively.Conclusions Combined testing of blood Hcy,hs-CRP and PLR can predict the development of cognitive dysfunction in patients with CSVD,which has great clinical value.