脂蛋白相关磷脂酶A2联合MRI总负荷评分对脑小血管病患者认知障碍的预测价值

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中图分类号：R743文献标志码：A DOI：10.11958/20252966

Abstract：ObjectiveTo investigate the predictive value of lipoprotein-associated phospholipaseA2 （Lp-PLA2） combined withthetotalburdenofmagneticresonance imaging （MRI）scoresoncognitiveimpairmentinpatientswithcerebral smallvessel disease（CSVD）.MethodsA totalof 178 CSVD patients admited to Gansu Wuwei Tumour Hospital （Gansu ProvinceWuwei Academyof Medical Sciences）fromJanuary2O23 to June2O24 were divided intothenormalcognition group （ n=89 ，MoCA≥26） and the cognitive impairment group （ n= 89，MoCA <2ℓ 5 points）.The CSVD total burden of MRI scores was evaluated by3.OTMRI.The baselinedata，Lp-PLA2 leveland the total burdenof MRI scores werecompared between the two groups.Logistic regresion wasapplied to analyze influencing factors of cognitive impairment in CSVD patients.Thepredictive valueofLp-PLA2levelcombined with thetotal burdenofMRIscoresoncognitiveimpairment in CSVD patients were analyzed byreceiver operating characteristic （ROC）curve.ResultsCompared with the normal cognitiongroup，Lp-PLA2levels，thetotalburdenofMRIscoresandIL-6weresignificantlyincreased inthecognitive impairment group （ P<0.05 ）. Results of multivariate Logistic regression analysis showed that increased Lp-PLA2 and the totalburden of MRI scores were risk factors for cognitive impairment in patients with CSVD（ P<0.05 ）.The area under curve （AUC）ofLp-PLA2levelscombinedwiththetotal burdenofMRI scores for predictingcognitive impairmentinpatients with CSVD was 0.905 （95%CI： 0.861-0.948）， the sensitivity was 86.5% and the specificity was 79.8%. Conclusion Lp-PLA2 levels andthe total burdenof MRIscores are increased inpatients withcognitive impairment，andthecombinationof both can serve as an early predictor of cognitive impairment in patients with CSVD.

Keywords：cerebral small vessel diseases；cognition disorders；1-alkyl-2-acetylglycerophosphocholine esterase; lipoprotein-associated phospholipase A2; the total burden of MRI scores

血管性认知障碍（vascular cognitive impairment，VCI）是指由脑血管病及其危险因素引起的一组从轻度认知损害到痴呆的综合征，有 15%～30% 的患者发展为痴呆，仅次于阿尔茨海默病[]。（剩余9139字）