急性脑梗死合并血管性痴呆患者认知功能与血清NRG-1、Lp-PLA2水平的相关性分析

Correlation analysis between cognitive function and serum NRG-1 and Lp-PLA2 levels in patients with acute cerebral infarction complicated with vascular dementia

目的探讨急性脑梗死合并血管性痴呆患者认知功能与血清神经调节蛋白1(NRG-1)、脂蛋白磷脂酶a2(Lp-PLA2)水平的相关性。方法在连云港市第一人民医院2019年1月—2022年1月收治的急性脑梗死合并血管性痴呆患者中选取102例,采用蒙特利尔认知评估量表(MoCA)评估认知功能,并根据评分情况分为轻中度组、重度组,对比两组一般资料[年龄、性别、体重指数(BMI)、血管性痴呆家族史、吸烟史、饮酒史、基础合并症]、血清指标(NRG-1、Lp-PLA2),绘制受试者工作特征(ROC)曲线分析NRG-1、Lp-PLA2对急性脑梗死合并血管性痴呆患者认知功能的评估价值,采用多因素Logistic回归分析明确重度认知功能障碍的危险因素。结果两组年龄、性别、BMI、血管性痴呆家族史、吸烟史、饮酒史等一般资料比较无统计学意义(P>0.05),轻中度组NRG-1水平高于重度组、Lp-PLA2水平低于重度组(P<0.05);经ROC分析证实NRG-1、Lp-PLA2能够用于评估急性脑梗死合并血管性痴呆患者认知功能,曲线下面积分别为0.952、0.655,P<0.05;多因素Logistic回归分析证实NRG-1≤196.36 pg/mL、Lp-PLA2≥147.33 ng/mL为急性脑梗死合并血管性痴呆患者重度认知功能障碍的危险因素(P<0.05)。结论对于急性脑梗死合并血管性痴呆患者可通过检测血清NRG-1、Lp-PLA2水平评估认知功能,NRG-1水平降低、Lp-PLA2水平升高可用做评估患者认知功能重度障碍的指标。

Objective To investigate the correlation between cognitive function and serum levels of neuregulin 1(NRG-1)and lipoprotein phospholipase a2(Lp-PLA2)in patients with acute cerebral infarction complicated with vascular dementia.Methods 102 patients with acute cerebral infarction complicated with vascular dementia admitted to our hospital from January 2019 to January 2022 were selected to evaluate their cognitive function using the Montreal Cognitive Assessment Scale(MoCA),and were divided into mild to moderate group and severe group according to their scores.General data[age,sex,body mass index(BMI),family history of vascular dementia,smoking history,alcohol consumption history,basic comorbidities]and serum markers(NRG-1,Lp-PLA2)were compared between the two groups.ROC curve was drawn to evaluate the cognitive function of NRG-1 and Lp-PLA2 in patients with acute cerebral infarction complicated with vascular dementia.Risk factors for severe cognitive impairment were identified using multivariate logistic regression analysis.Results There was no statistically significant difference in general data such as age,gender,BMI,family history of vascular dementia,smoking history,and drinking history between the two groups(P>0.05).The NRG-1 level in the mild to moderate group was higher than that in the severe group,and the Lp-PLA2 level was lower than that in the severe group(P<0.05).ROC analysis proved that NRG-1 and Lp-PLA2 could be used to evaluate cognitive function in patients with acute cerebral infarction complicated with vascular dementia,and the area under the curve were 0.952 and 0.655,respectively,P<0.05.Multivariate Logistic regression analysis confirmed that NRG-1≤196.36 pg/mL and Lp-PLA2≥147.33 ng/mL were risk factors for severe cognitive impairment in patients with acute cerebral infarction complicated with vascular dementia(P<0.05).Conclusion For patients with acute cerebral infarction complicated with vascular dementia,the cognitive function can be assessed by detecting serum NRG-1 and Lp-PLA2 levels,and the decrease of NRG-1 level and the increase of Lp-PLA2 level can be used as indicators to evaluate the severe cognitive dysfunction of patients.