脑动脉狭窄程度及载脂蛋白B/低密度脂蛋白胆固醇比值与血管性认知障碍相关性及临床应用价值

Correlation between the degree of cerebral artery stenosis, ApoB/LDL ratio and vascular cognitive impairment and the value of guiding clinical treatment

目的 探究脑动脉狭窄程度及载脂蛋白(Apo)B/低密度脂蛋白胆固醇(LDL)比值与血管性认知障碍(VCI)的相关性及临床应用的价值。方法 回顾性分析本院2020年10月至2022年10月收治的脑梗死患者88例的临床资料,按发病4 d内简易精神状态量表(MMSE)得分将其分为49例VCI组与39例单纯梗死组,按认知障碍不同将VCI患者分为24例血管性痴呆组与25例轻度认知功能障碍(MCI)组。全部患者均行头颅磁共振血管造影及ApoB、LDL检测,分析脑动脉狭窄程度及ApoB/LDL比值与VCI的相关性。结果 单纯梗死组脑动脉狭窄程度优于VCI组(P<0.05)。MCI组脑动脉狭窄程度优于VCI组(P<0.05);Spearman相关性分析显示,脑动脉狭窄程度与VCI呈正相关(P<0.05)。单纯梗死组ApoB/LDL比值比VCI组高(P<0.05)。MCI组ApoB/LDL比值比血管性痴呆组高(P<0.05);Spearman相关性分析显示,ApoB/LDL比值与VCI呈负相关(P<0.05)。单纯梗死组糖尿病、高血脂比例比VCI组低(P<0.05)。有序Logistic回归分析显示,脑动脉狭窄程度、ApoB/LDL比值、糖尿病、高血脂均为VCI的独立影响因素(P<0.05)。结论 脑动脉狭窄程度及ApoB/LDL比值与血管性认知障碍密切相关,在临床治疗中具有重要指导价值。

Objective To explore the correlation between the degree of cerebral artery stenosis,the ratio of apolipoprotein(Apo)B/low density lipoprotein(LDL)and vascular cognitive impairment(VCI),and the value of guiding clinical treatment.Methods The clinical data of 88 patients with cerebral infarction admitted to our hospital from October 2020 to October 22 were retrospectively analyzed.They were divided into 49 patients with VCI and 39 patients with simple infarction according to the scores of mini-mental state examination(MMSE)within 4 days after the onset of the disease.VCI patients were divided into 24 patients with vascular dementia and 25 patients with mild cognitive impairment(MCI)according to different cognitive disorders.All patients were examined by cranial magnetic resonance angiography,ApoB and LDL to analyze the degree of cerebral artery stenosis and the correlation between ApoB/LDL ratio and VCI.Results The degree of cerebral artery stenosis in the simple infarction group was better than that in the VCI group(P<0.05).The degree of cerebral artery stenosis in the MCI group was better than that VCI group(P<0.05).Spearman correlation analysis showed that the degree of cerebral artery stenosis was positively correlated with VCI(P<0.05).ApoB/LDL ratio in the simple infarction group was higher than that in the VCI group(P<0.05).The ratio of ApoB/LDL in the MCI group was higher than that in the vascular dementia group(P<0.05).Spearman correlation analysis showed that ApoB/LDL ratio was negatively correlated with VCI(P<0.05).The ratio of diabetes and hyperlipidemia in the simple infarction group was lower than that in the VCI group(P<0.05).Logistic regression analysis showed that the degree of cerebral artery stenosis,ApoB/LDL ratio,diabetes and hyperlipidemia were all independent influencing factors of VCI(P<0.05).Conclusion The degree of cerebral artery stenosis and the ratio of ApoB/LDL are closely related to vascular cognitive impairment,which has important guiding value in clinical treatment.