血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能的相关性研究

Correlation between serum cortisol and cognitive function in patients with vascular mild cognitive impairment with kidney yang deficiency syndrome

目的探讨血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能之间的关系。方法选取64例血管性轻度认知障碍肾阳虚证患者。根据血清皮质醇中位数分为高皮质醇组和低皮质醇组,各32例,收集患者一般临床资料、血清皮质醇指标,并进行神经心理学量表及肾阳虚量表测评。采用相关性分析及线性回归分析探讨血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能之间的关系。结果与低皮质醇组相比,高皮质醇组的高血压病、脑血管病比例更高,MoCA、MMSE、AESC量表评分更低(P<0.05),ADL、HAMD、肾阳虚证辨识量表评分更高(P<0.05)。相关性分析结果显示高皮质醇与ADL、HAMD、肾阳虚辨识量表评分均呈正相关,与MoCA、MMSE、AESC量表评分均呈负相关(P<0.001)。线性回归分析结果显示高皮质醇为MoCA量表评分的独立危险因素,血管性轻度认知障碍肾阳虚证患者的血清皮质醇水平越高,MoCA量表评分越低(P<0.001),认知损害越严重。结论血清皮质醇的升高可能是血管性轻度认知障碍肾阳虚证患者认知功能损害的潜在因素。

Objective To investigate the relationship between serum cortisol and cognitive function in patients with vascular mild cognitive impairment with the kidney yang deficiency syndrome.Methods Sixty-four patients with vascular mild cognitive impairment with the syndrome of kidney yang deficiency were selected.According to the median serum cortisol,they were divided into 32 cases each in the high cortisol group and the low cortisol group.General clinical data,serum cortisol indexes,and neuropsychological scale scores and kidney yang deficiency scale scores were collected from the patients.Correlation analysis and linear regression analysis were used to explore the relationship between serum cortisol and cognitive function in patients with vascular mild cognitive impairment with the kidney yang deficiency syndrome.Results Compared with the low cortisol group,the high cortisol group had a higher proportion of hypertension and cerebrovascular disease,lower scores on the MoCA,MMSE,and AESC scales(P<0.05),and higher scores on the ADL,HAMD,and kidney yang deficiency syndrome recognition scales(P<0.05).The results of correlation analysis showed that hypercortisol was positively correlated with the ADL,HAMD,and kidney yang deficiency recognition scale scores,and negatively correlated with the MoCA,MMSE,and AESC scale scores(P<0.001).Linear regression analysis showed that high cortisol was an independent risk factor for the MoCA scale scores,and the higher the serum cortisol level in patients with vascular mild cognitive impairment with the kidney yang deficiency syndrome,the lower the MoCA scale scores(P<0.001)and the more severe the cognitive impairment.Conclusion Elevated serum cortisol may be a potential factor for cognitive impairment in patients with vascular mild cognitive impairment with the kidney yang deficiency syndrome.