陈文超 1吴恺迪 1顾诗渊 1史路遥 1熊艺彤 1任占云 1许清波1
作者信息
摘要
Abstract
Objective To explore the value of blood pressure variability combined with high-sensitivity C-reactive protein(hs-CRP)in evaluating cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods A total of 125 patients with CSVD admitted to Yixing people's hospital from January 2024 to December 2024 were selected as the research objects.According to the Montreal Cognitive Scale(MoCA)score,the CSVD patients were divided into cognitive impairment group(MoCA score＜26 points,74 cases)and non-cognitive impairment group(MoCA score ≥ 26 points,51 cases).The general data,laboratory parameters and blood pressure variability indicators of the two groups were compared.The relationships between blood pressure variability indicators,hs-CRP and MoCA score were analyzed by stratified regression.Multivariate Logistic regression analysis was conducted to analyze the factors affecting patients' cognitive impairment.The impact of the interaction between hs-CRP and blood pressure variability indicators on the risk of cognitive impairment were analyzed.ROC curves were used to analyze the predictive power of blood pressure variability and hs-CRP alone and in combination on cognitive impairment.Results Numbers of perivascular spaces(PVS),homocysteine(Hcy),lipoprotein-associated phospholipase A2(Lp-PLA2),hs-CRP,24 h mean systolic blood pressure(24 h MSBP),24 h systolic coefficient of variation(24 h SBP-CV),and 24 h mean pulse pressure difference(24 h MPP)in the cognitive impairment group were significantly higher than those in the non-cognitive impairment group(all P＜0.05).The results of stratified regression analysis showed that 24 h MSBP,24 h SBP-CV,24 h MPP,and hs-CRP all had significant negative effects on MoCA(all P＜0.05).Multivariate Logistic regression analysis showed that increases in numbers of PVS,Hcy,Lp-PLA2,hs-CRP,24 h MSBP,24 h SBP-CV,and 24 h MPP were risk factors for cognitive impairment in patients(all P＜0.05).Interaction analysis results showed that in Model 1(unadjusted for gender and age)and Model 2(adjusted for gender and age),there were no multiplicative and additive interactions between hs-CRP and 24 h MSBP,24 h SBP-CV,and 24 h MPP,respectively(all P＞0.05).The areas under the ROC curve for 24 h MSBP,24 h SBP-CV,24 h MPP,and hs-CRP alone and combined were 0.752,0.809,0.686,0.813,0.840,respectively.Conclusions Blood pressure variability and hs-CRP are related to cognitive function in patients with CSVD.The combination of the two can improve the predictive efficiency of patients with cognitive impairment and is conducive to early clinical diagnosis and intervention.关键词
脑小血管病/认知障碍/血压变异性/超敏C反应蛋白Key words
cerebral small vessel disease/cognitive impairment/blood pressure variability/high-sensitivity C-reactive protein分类
医药卫生
