血管性认知障碍患者血清胱抑素C水平研究

目的 明确血清胱抑素C(CysC)在血管性认知障碍(VCI)患者中的表达，探讨两者间的相关性及CysC的临床预测价值。方法 纳入蚌埠医学院第一附属医院2021年1月—2022年2月诊治的VCI患者96例。根据患者日常生活能力及蒙特利尔认知量表(MoCA)评分将患者分为血管性痴呆(VaD)组(35例)和血管性认知障碍非痴呆(VCIND)组(61例),另选取83例认知和颅脑CT/MRI均表现正常的健康老人为对照(NC)组。比较3组基线资料及CysC水平，分析CysC与VCI患者总体认知及特定认知域的关系，采用二元logistic回归分析和ROC曲线评估VCI发生的相关危险因素及CysC对其发生的预测价值。结果 3组年龄、高血压、糖尿病、卒中史、CysC和MoCA评分差异有统计学意义(均P<0.05);NC组、VCIND组和VaD组CysC表达水平依次升高，两两比较差异有统计学意义(均P<0.05);CysC与VCI患者MoCA总评分以及视空间与执行力、命名、计算与注意力、语言、定向、延迟记忆呈负相关关系(均P<0.05);Logistic回归分析显示CysC表达升高可能是...

Study of serum cystatin C levels in patients with vascular cognitive impairment

  Objective  To determine the expression of serum cystatin C (CysC) in patients with vascular cognitive impairment (VCI), and to explore the correlation between them and the clinical predictive value of CysC.  Methods  This study included 96 patients with VCI who were enrolled in the First Affiliated Hospital of Bengbu Medical College from January 2021 to February 2022. They were divided into vascular dementia group (VaD, n=35) and vascular cognitive impairment without dementia group (VCIND, n=61) according to the Montreal Cognitive Assessment (MoCA) and ability of daily living (ADL) scores. In addition, 83 healthy elderly with normal cognitive function and brain MRI/CT were selected as normal controls (NC group). Baseline data and serum CysC levels were compared to analyse the relationship of CysC with overall cognition and its specific cognitive domains in patients with VCI. Binary logistic regression and ROC curves were used to evaluate VCI-related risk factors and the predictive value of CysC for the occurrence of VCI.  Results  Significant differences in age, history of hypertension, diabetes, stroke, MoCA scores and CysC were found among the three groups (all P < 0.05). The serum CysC expression increased sequentially in the NC, VCIND and VaD groups, and the differences were statistically significant (all P < 0.05). CysC was negatively correlated with MoCA overall cognition, visual space and executive function, naming, attention and computation, language, delayed memory and orientation in the VCI group (all P < 0.05). The results of multivariate logistic regression model indicated that higher levels of CysC were independent risk factors for VCI (P < 0.05). ROC curve analysis showed that the area under curve (AUC) for predicting the occurrence of VCI by serum CysC level was 0.758, the sensitivity was 70.8%, the specificity was 77.1% and the optimal cut-off value was 0.99 mg/L.  Conclusion  Serum CysC is highly expressed in VCI and is related to the severity of cognitive impairment. It is an independent influencing factor of cognitive impairment and is expected to become a biological indicator for early assessment of VCI.