脑小血管病患者认知功能障碍与尿酸的相关性研究

Correlation between cognitive impairment and serum uric acid in patients with cerebral small vessel disease

目的探讨脑小血管病(CSVD)患者认知功能障碍与血清尿酸水平的关系。方法将131例CSVD患者按蒙特利尔评估量表(MoCA)评分分为认知功能障碍组(59例)和对照组(72例),检测两组患者血清尿酸、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、同型半胱氨酸(Hcy)、纤维蛋白原(FIB)水平。CSVD患者血清尿酸与认知功能的相关性采用Pearson积矩相关分析,并采用多因素Logistic回归分析进行验证。结果与对照组相比,认知功能障碍组年龄较大,受教育年限及血清尿酸水平较低,Hcy水平升高,MoCA总分及视空间与执行功能、注意力、抽象能力、延迟回忆、定向力评分降低,差异均有统计学意义(P<0.05或0.01)。CSVD患者血清尿酸与MoCA总分及视空间与执行功能、抽象能力、定向力评分呈显著正相关(P<0.05或0.01)。多因素Logistic回归分析显示,年龄较大和Hcy水平较高是CSVD患者发生认知功能障碍的危险因素,而受教育年限较长和血清尿酸水平较高则是其保护因素(P<0.05或0.01)。结论CSVD患者认知功能障碍与血清尿酸有关,血清尿酸高水平可以防止CSVD患者认知功能障碍的发生。

Objective To explore the correlation between cognitive impairment and serum uric acid(UA)level in patients with cerebral small vessel disease(CSVD).Methods A total of 131 CSVD patients were assigned to cognitive impairment(CI,n=59)and control(n=72)group according to scores on Montreal Cognitive Assessment(MoCA),such indexes of both groups detected as serum UA,triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterin(LDL-C),high homocysteine density lipoprotein cholesterin(HDL-C),homocysteine(Hcy)and fibrinogen(FIB).The correlation between the serum UA and cognitive function was analyzed using Pearson product moment correlation(PPMC)and tested u si ng multivariate logistic regression analysis.Results Compared with control group patients'ages were older,education years and serum UA levels lower,Hcy level elevated,and the total,visuospatial and executive function,attention,abstraction,delayed recall and orientation score of the MoCA lowered in CI group,differences statistically significant(P<0.05 or 0.01).Serum UA levels of the CSVD patients were significantly positively related to the total,visuospatial and executive function,abstraction and orientation score of the MoCA(P<0.05 or 0.01).Multivariate logistic regression analysis showed that older age and higher Hcy levels were risk factors of cognitive impairment in CSVD patients,longer education years and higher serum UA levels protective factors(P<0.05 or 0.01).Conclusion Cognitive impairment of CSVD patient is related serum UA levels and high UA level can prevent the occurrence of cognitive impairment.