老年轻型急性缺血性卒中后认知障碍与血清β2微球蛋白的关系研究

目的 探讨血清β2微球蛋白水平与老年轻型急性缺血性卒中后认知障碍的关系，为预防老年轻型 卒中后认知障碍提供依据。 方法 回顾性分析2015年1月-2018年9月在北京中医药大学东方医院脑病科住院的老年轻型急性 缺血性卒中患者的临床资料，所有入组病例均在入院第2天采集空腹肘静脉血测定血清β2微球蛋白、 LDL-C、HDL-C等生化指标；发病第10～14天使用北京版MoCA量表进行评测，分为认知障碍组（MoCA评 分＜26分）和无认知障碍组（MoCA评分≥26分），通过统计学分析，探讨老年轻型急性缺血性卒中后 认知障碍与血清β2微球蛋白之间的关系。 结果 研究共纳入106例老年轻型急性缺血性卒中患者，其中认知障碍组66例，无认知障碍 组40例。认知障碍组患者血清β2微球蛋白水平（P =0.040）、年龄（P =0.004）、高血压患者比例 （P =0.027）均高于无认知障碍组。多因素Logistic回归分析结果显示血清β2微球蛋白水平（OR 2.645， 95%CI 1.145～6.110，P =0.023）、年龄（OR 1.112，95%CI 1.041～1.188，P =0.002）、高血压（OR 2.806， 95%CI 1.057～7.452，P =0.038）是老年轻型急性缺血性卒中后认知障碍的危险因素。 结论 血清β2微球蛋白升高是老年轻型急性缺血性卒中后认知障碍的危险因素之一，血清β2微球 蛋白水平较高的老年轻型急性缺血性卒中患者应给予重视。

Correlation between Cognitive Impairment and Serum β2 Microglobulin Level in Eldly Patients with Acute Minor Ischemic Stroke

Objective To investigate the relationship between cognitive impairment and serum β2
microglobulin level in eldly patients with acute minor ischemic stroke.
Methods Clinical data of elderly patients with acute minor ischemic stroke who were admitted to
the Department of Encephalopathy, Dongfang Hospital of Beijing University of Chinese Medicine
from January 2015 to September 2018 were retrospective analyzed. Serum β2 microglobulin
was measured on the next day after admisson. On the 10th-14th day (the condition is stable and
delirium is excluded), all patients were assessed using the Beijing version of MoCA and divided
into cognitive impairment group (MoCA <26 points) and non-cognitive impairment group (MoCA
≥26 points). The relationship between cognitive impairment and serum β2 microglobulin in eldly
patients with acute minor ischemic stroke was analyzed.
Results A total of 106 elderly patients with acute minor ischemic stroke were included in this study,
with 66 patients in cognitive impairment group and 40 patients in non-cognitive impairment group.
Serum β2 microglobulin levels (P =0.040), age (P =0.004) and the percentage of hypertension (P =0.027)in the cognitive impairment group were all higher than that in non-cognitive impairment group.
Multivariate logistic regression analysis showed that serum β2 microglobulin level (OR 2.645, 95%CI
1.145-6.110, P =0.023), age (OR 1.112, 95%CI 1.041-1.188, P =0.002) and hypertension (OR 2.806,
95%CI 1.057-7.452, P =0.038) was independent risk factors for cognitive impairment in eldly patients
with acute minor ischemic stroke.
Conclusions Serum β2 microglobulin is one of the risk factors for cognitive impairment in eldly
patients with acute minor ischemic stroke.