非痴呆性血管性认知障碍的影响因素研究

目的探讨非痴呆性血管性认知障碍的影响因素。方法选取唐山市工人医院2014年1月-2016年1月非痴呆性血管性认知障碍(vascular cognitive impairment no dementia,VCIND)患者为研究对象,同期认知功能正常者为对照组。对比VCIND组和对照组的血管病危险因素、生化指标、甲状腺激素水平的差异,采用Logistic回归分析VCIND的独立危险因素。结果研究共纳入VCIND组115例,对照组147例。VCIND组患者高血压(73.9%vs 53.1%,P=0.001)及既往卒中史(60.9%vs 34.7%,P0.001)比例显著高于对照组。VCIND组空腹血糖(P0.001)、同型半胱氨酸(P0.001)、甘油三酯水平显著高于对照组(P=0.022)。VCIND组游离三碘甲状腺原氨酸(free triiodothyronine,FT3)水平显著低于对照组(2.80±0.39)pg/ml vs(2.90±0.27)pg/ml,P=0.043]。多因素分析显示,卒中病史比值比(odds ratio,OR)6.461,95%可信区间(confidence interval,CI)2.835~14.725,P0.001]、同型半胱氨酸(OR 15.726,95%CI 7.198~34.358,P0.001)、血糖水平(OR 1.864,95%CI 1.367~2.541,P0.001)是VCIND的独立危险因素,而FT3(OR 0.351,95%CI0.192~0.647,P0.001)是VCIND的保护性因素。结论卒中病史、高血糖水平、高同型半胱氨酸血症是VCIND的独立危险因素,而FT3是VCIND的保护性因素。

The Study on Inlfuencing Factors of Vascular Cognitive Impairment no Dementia

Objective To investigate the influencing factors of vascular cognitive impairment no dementia (VCIND). Methods Patients with VCIND in Tangshan Gongren Hospital from January 2014 to January 2016 were recruited into the study group and patients with no cognitive impairment were enrolled into the control group. The differences of vascular risk factors, laboratory data and thyroid hormone were compared between two groups. Logistic regression analysis was used to analyze the independent risk factor. Results There were 115 cases in the study group with VCIND and 147 in the control group. The proportion of hypertension (73.9%vs 53.1%,P=0.001), history of stroke (60.9%vs 34.7%, P<0.001) in the VCIND group was signiifcantly higher than that in the control group. The level of fasting blood glucose (Glu)(P<0.001), homocysteine (Hcy)(P<0.001) and triglyceride (P=0.022) in the VCIND group were signiifcantly higher than that of the control group. The free triiodothyronine (FT3) in the VCIND group was proved lower than that in the control group (2.80±0.39] pg/mlvs 2.90±0.27] pg/ml,P=0.043]. Multivariate Logistic regression analysis showed: history of stroke (odds ratioOR] 6.461, 95% confidence interval CI] 2.835-14.725,P<0.001), Hcy OR 15.726, 95%CI 7.198-34.358,P<0.001], blood Glu OR 1.864, 95%CI 1.367-2.541,P<0.001] were independent risk factors of VCIND, and FT3 OR 0.351, 95%CI 0.192-0.647,P<0.001] were the protective factors of VCIND. Conclusion History of stroke, Hcy and high blood Glu level are independent risk factors of VCIND, while FT3 is the protective factor of VCIND.