2020 年第 9 期 第 15 卷

不同认知功能腔隙性脑梗死患者血尿酸和同型半胱氨酸及高敏C反应蛋白水平的差异

Analysis of serum uric acid, homocysteine and high-sensitivity C-reactive protein levels in patients with lacunar infarction of different cognitive function

作者：范月辉1刘惠钦1李伟峰1何雪辉2吕士英3李献军

英文作者：Fan Yuehui1 Liu Huiqin1 Li Weifeng1 He Xuehui2 Lyu Shiying3 Li Xianjun1

单位：1石家庄市第一医院神经内四科 050000； 2石家庄市第一医院心内一科 050000； 3石家庄市第一医院影像中心 050000

英文单位：1The Fourth Department of Neurology  the First Hospital of Shijiazhuang Shijiazhuang 050000 China;  2the First Department of Cardiology the First Hospital of Shijiazhuang Shijiazhuang 050000 China; 3Imaging Center the First Hospital of Shijiazhuang Shijiazhuang 050000 China

关键词：腔隙性脑梗死；血尿酸；同型半胱氨酸；高敏C反应蛋白；认知功能

英文关键词：Lacunarcerebralinfarction;Serumuricacid;Homocysteine;High-sensitivityC-reactiveprotein;Cognitivefunction

• 摘要：

• 目的 研究不同认知功能腔隙性脑梗死患者血尿酸、同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)水平的差异。方法 选择2018年12月至2019年12月石家庄市第一医院收治的腔隙性脑梗死患者100例，将患者根据简易精神状态检查量表(MMSE)评分分为认知功能正常组(40例)、轻度认知功能障碍组(40例)和痴呆组(20例)，同期选择100例体检健康者作为对照组。比较各组血清指标、磁共振成像指标、神经功能、日常生活质量。分析腔隙性脑梗死患者认知功能的影响因素。结果 痴呆组血尿酸、Hcy、hs-CRP水平高于轻度认知功能障碍组、认知功能正常组、对照组［血尿酸：（466±52）μmol/L比（414±47）、（363±51）、（179±23）μmol/L，Hcy：（19.4±2.9）μmol/L比（17.4±2.4）、（15.4±3.5）、（6.8±1.1）μmol/L，hs-CRP：（18.6±3.2）mg/L比（15.4±4.3）、（13.6±3.2）、（3.5±1.0）mg/L］，轻度认知功能障碍组血尿酸、Hcy、hs-CRP水平高于认知功能正常组、对照组，认知功能正常组血尿酸、Hcy、hs-CRP水平高于对照组，差异均有统计学意义(均P＜0.01)。腔隙性脑梗死患者梗死灶数目、梗死灶总体积随认知功能障碍加重而增多/增大，美国国立卫生研究院卒中量表评分随病情加重升高、健康状况调查问卷评分随病情加重减低，组间两两比较差异均有统计学意义（均P<0.01）。多因素Logistic回归分析结果显示血尿酸、Hcy、hs-CRP、梗死灶数目、梗死灶总体积均是腔隙性脑梗死患者认知功能障碍的影响因素(均P<0.01)。结论 血尿酸、Hcy、hs-CRP、梗死灶数目、梗死灶总体积均是腔隙性脑梗死患者发生认知功能障碍的影响因素，且病情严重患者上述指标水平较高。

• Objective To analyze the difference of serum uric acid(UA), homocysteine(Hcy) and high-sensitivity C-reactive protein(hs-CRP) levels in patients with lacunar infarction of different cognitive function. Methods  Totally 100 patients with lacunar cerebral infarction admitted to the First Hospital of Shijiazhuang from December 2018 to December 2019 were divided into normal cognitive function group(40 cases), mild cognitive dysfunction group(40 cases) and dementia group(20 cases) according to the mini-mental state examination(MMSE) results; 100 cases of physical examinees were as control group. Serum indexes, magnetic resonance imaging indexes, neurological deficits quality of life scores of each group and the influencing factors of cognitive function in patients with lacunar cerebral infarction were analyzed by multivariate analysis. Results The levels of UA, Hcy, and hs-CRP in the dementia group were higher than those in the mild cognitive dysfunction group, normal cognitive function group, and control group［UA:（466±52）μmol/L vs （414±47）, （363±51）, （179±23）μmol/L; Hcy: （19.4±2.9）μmol/L vs （17.4±2.4）, （15.4±3.5）, （6.8±1.1）μmol/L; hs-CRP:（18.6±3.2）mg/L vs （15.4±4.3）, （13.6±3.2）, （3.5±1.0）mg/L］(all P<0.01). The levels of UA, Hcy, hs-CRP in the mild cognitive dysfunction group were higher than those in the normal cognitive function group and the control group (all P<0.01). Dementia group had the highest score of National Institute of Health Stroke Scale and the lowest score of the short form-36 health survey (all P<0.01). Logistic analysis showed that UA, Hcy, hs-CRP, number and volume of infarcted lesions were the factors affecting cognitive impairment in patients with lacunar infarction(all P<0.01). Conclusion UA, Hcy, hs-CRP, number and volume of infarcted lesions are the factors affecting cognitive impairment in patients with lacunar infarction and correlated with the disease severity degrees.