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尿酸在脑小血管病认知障碍中的作用

The effect of uric acid in cognitive impairment of cerebral small vessel disease

摘要:

目的 探讨尿酸在脑小血管病及其认知障碍中的作用.方法 102例脑小血管病(cerebral small vessel disease,CSVD)和56例非脑小血管病(NCSVD)患者被纳入研究,通过颅脑MRI评估患者CSVD影像学表现,神经心理学测试评估患者认知功能并检测血清中尿酸浓度.在所有患者中比较CSVD患者与NCSVD患者血清尿酸水平差异,Logistic回归分析CSVD的危险因素;在CSVD患者中比较伴与不伴高尿酸血症(hyperuricemia,HUA)患者认知功能差异以及偏相关分析尿酸与CSVD患者认知功能的相关性.结果 CSVD患者血清尿酸水平高于NCSVD患者[分别为(360.31±78.31) μmol/L,(301.79 ±49.37) μmol/L,P<0.05)],尿酸是CSVD的危险因素(OR=1.014,95%CI=1.007~ 1.021,P<0.05);在CSVD患者中,NHUA(非高尿酸血症)患者与HUA患者在MMSE、VFT、DSST及TMT-A评分差异具有统计学意义[MMSE (23.76 ±3.09)分,(22.27 ±3.87)分;VFT(34.29 ±8.01)分,(31.85 ±6.16)分;DSST(34.39 ± 7.84)个,(31.15 ±7.47)个;TMT-A (59.10 ± 17.52),(65.98±15.97),均P<0.05].尿酸与MoCA、DST、VFT评分呈负相关(r=-0.178,P=0.039;r=-0.202,P=0.018;r=-0.250,P=0.004),与TMT-B用时呈正相关(r=0.241,P=0.005).结论 尿酸是CSVD的危险因素,并可能损害CSVD患者的整体认知功能、注意力、语言以及执行功能.

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Objective To explore the effect of uric acid in cerebral small vessel disease and its cognitive impairment.Methods 102 patients with cerebral small vessel disease(CSVD)and 56 patients with NCSVD (non-CSVD) were enrolled.The CSVD imaging manifestations was assessed by brain MRI.Neuropsychological test was used to evaluate the cognitive function and serum uric acid concentration was detected.The uric acid levels was compared in CSVD and NCSVD groups and Logistic regression was used to assess the risk factor of CSVD.In patients with CSVD,the cognitive function was compared between the patients with and without hyperuricemia and partial correlation analysis was used to assess the relationship between uric acid and cognitive function.Results The serum uric acid level of patients with CSVD was higher than that of patients with NCSVD ((360.31 ±78.31) μmol /L,(301.79±49.37) μmol/L,P<0.05).Uric acid was risk factor for patients with CSVD (OR=1.014,95%CI=1.007-1.021,P<0.05).In patients with CSVD,there were significant differences in MMSE,VFT,DSST and TMT-A scores between patients with and without hyperuricemia (MMSE (23.76± 3.09) vs (22.27 ± 3.87);VIT (34.29 ± 8.01) vs (31.85 ± 6.16);DSST (34.39 ± 7.84) vs (31.15±7.47);TMT-A(59.10±17.52) vs (65.98±15.97),all P<0.05).Uric acid was negatively correlated with MoCA,DST and VFT scores (r=-0.178,P=0.039;r=-0.202,P=0.018;r=-0.250,P=0.004),and positively correlated with TMT-B time cost (r=0.241,P=0.005).Conclusion Uric acid is a risk factor for CSVD and may damages the overall cognitive function,attention,language and executive function of patients with CSVD.

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作者: 吴艳红 [1] 章军建 [1] 吴冬梅 [1] 范元腾 [1] 孙冬 [1]
栏目名称: 认知功能障碍专题
DOI: 10.3760/cma.j.issn.1674-6554.2018.08.005
发布时间: 2018-09-13
基金项目:
National Natural Science Foundation of China (81371196)国家自然科学基金项目
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