脑小血管病患者认知功能与血清神经丝轻链蛋白、同型半胱氨酸水平的关系研究

Study on correlation of cognitive function and serum neurofilament light chain and homocysteine levels in patients with cerebral small vessel disease

目的探究脑小血管病(CSVD)患者认知功能与血清神经丝轻链蛋白(NFL)、同型半胱氨酸(Hcy)水平的关系。方法100例脑小血管病患者,根据蒙特利尔认知评估量表(MoCA)评分不同分为认知正常组和认知障碍组,每组50例。采集基础资料,检测两组血清神经丝轻链蛋白、同型半胱氨酸水平。采用多因素Logistic回归分析脑小血管病患者认知功能障碍的影响因素,采用Pearson相关分析神经丝轻链蛋白、同型半胱氨酸水平与脑小血管病患者认知功能的相关性。结果认知障碍组血清神经丝轻链蛋白、同型半胱氨酸水平分别为(200.89±11.25)pg/ml、(39.58±6.34)μmol/L,均高于认知正常组的(168.57±11.34)pg/ml、(30.54±7.12)μmol/L,差异均有统计学意义(P<0.05)。Pearson相关分析显示:血清神经丝轻链蛋白、同型半胱氨酸水平与脑小血管病患者MoCA评分均呈显著负相关(r=-0.658、-0.756,P<0.05)。两组患者年龄、性别、受教育年限、饮酒史、吸烟史、冠心病史比较差异无统计学意义(P>0.05);认知障碍组患者高血压史、糖尿病史占比高于认知正常组,MoCA评分低于认知正常组,差异具有统计学意义(P<0.05)。Logistic回归分析显示:高血压史与血清神经丝轻链蛋白、同型半胱氨酸水平为脑小血管病患者认知障碍的影响因素(P<0.05)。结论血清神经丝轻链蛋白、同型半胱氨酸水平与脑小血管病患者认知功能相关,血清神经丝轻链蛋白、同型半胱氨酸水平是脑小血管病发生认知障碍的影响因素,在脑小血管病患者或疑似脑小血管病患者中对其进行检测具有重要意义,可为脑小血管病的早期诊断以及预后诊疗提供参考。

Objective To explore the correlation of cognitive function and serum neurofilament light chain(NFL)and homocysteine(Hcy)levels in patients with cerebral small vessel disease(CSVD).Methods 100 patients with cerebral small vascular disease were divided into cognitive normal group and cognitive impairment group according to different scores of Montreal Cognitive Assessment Scale(MoCA),with 50 cases in each group.Basic data were collected and serum levels of serum neurofilament light chain and homocysteine were detected.Multivariate Logistic regression was used to analyze the influencing factors of cognitive dysfunction in patients with cerebral small vessel disease,and Pearson correlation was used to analyze the correlation of cognitive function and serum neurofilament light chain and homocysteine levels in patients with cerebral small vessel disease.Results The levels of serum neurofilament light chain in the cognitive impairment group were(200.89±11.25)pg/ml and(39.58±6.34)μmol/L,respectively,which were higher than(168.57±11.34)pg/ml and(30.54±7.12)μmol/L in the cognitive normal group,respectively.The differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum neurofilament light chain and homocysteine levels were significantly negatively correlated with MoCA scores in patients with cerebral small vessel disease(r=-0.658,-0.756;P<0.05).There was no significant difference in age,sex,years of education,history of drinking,history of smoking and history of coronary heart disease between the two groups(P>0.05).The history of hypertension and diabetes mellitus in the cognitive impairment group was higher than that in the cognitive normal group,and the MoCA score was lower than that in the cognitive normal group.The difference was statistically significant(P<0.05).Logistic regression analysis showed that the history of hypertension and the levels of serum neurofilament light chain and homocysteine were the influencing factors of cognitive impairment in patients with cerebral small vessel disease(P<0.05).Conclusion Serum neurofilament light chain and homocysteine levels are correlated with cognitive function in patients with cerebral small vascular disease.The levels of serum neurofilament light chain and homocysteine are the risk factors of cognitive impairment in cerebral small vascular disease,and the detection of neurofilament light chain and homocysteine in patients with cerebral small vascular disease or suspected cerebral small vascular disease is of great significance,which can provide reference for the early diagnosis and prognosis of cerebral small vascular disease.