摘要
目的分析脑小血管病(SVD)患者总MRI脑小血管病评分与非痴呆型血管性认知损害(VCI-ND)的相关性及其预测价值。方法以162例SVD患者为研究对象,发生VCI-ND者为认知损害组(95例),未发生VCI-ND者为认知正常组(67例)。采用多变量logistic回归分析确定总MRI脑小血管病评分与VCI-ND的独立相关性,受试者工作特征曲线(ROC曲线)评估其预测价值。结果认知损害组与认知正常组在年龄、高血压、糖尿病、既往卒中或短暂性脑缺血发作(TIA)史、吸烟、收缩压、舒张压、空腹血糖和总MRI脑小血管病评分比较差异有统计学意义(P<0.05),而在性别、饮酒和高脂血症比较差异无统计学意义(P>0.05)。调整混杂因素后,总MRI脑小血管病评分为3分(OR=8.952,95%CI:3.827~15.316,P<0.001)或4分(OR=5.958,95%CI:3.073~11.367,P<0.001)是SVD患者发生VCI-ND的独立危险因素;总MRI脑小血管病评分预测SVD患者发生VCI-ND的曲线下面积为0.853(95%CI:0.794~0.912),最佳截断值为3,灵敏度和特异度分别为54.7%和92.5%。结论总MRI脑小血管病评分预测血管性认知损害的价值较高。
Objective To analyze the association between total MRI cerebral small vessel disease(SVD)score and vascular cognitive impairment no-dementia(VCI-ND)in SVD patients and evaluate its predictive value.Methods A total of 162 SVD patients were collected.Among them,SVD patients with VCI-ND were defined as the cognitive impairment group(n=95),and SVD patients without VCI-ND were defined as the normal cognitive group(n=67).Logistic regression analysis was performed to analyze the independent correlation between total MRI cerebral small vessel disease score and VCI-ND in SVD patients,and receiver operator characteristic(ROC)curve was used to evaluate its predictive value.Results Age,hypertension,diabetes,history of previous stroke or transient is chemic attack(TIA),smoking,systolic pressure,diastolic blood pressure,fasting plasma glucose and total MRI brain small vessel disease score showed statistically significant differences between the normal cognitive group and the cognitive impairment group(P<0.05),but there was no statistical significance difference in gender,drinking,and hyperlipidemia(P>0.05).After adjusting for confounding factors,the total MRI score of cerebral microvascular disease was 3(OR=8.952,95%CI:3.827-15.316,P<0.001)or 4(OR=5.958,95%CI:3.073-11.367,P<0.001),which is an independentrisk factor for VCI-ND in SVD patients.The area under the curve of VCI-ND in patients was 0.853(95%CI:0.794-0.912),of which the optimal cutoff point was 3,and sensitivity and specificity was 54.7%and 92.5%,respectively.Conclusion The value of total MRI cerebral small vessel disease(SVD)score in predicting vascular cognitive impairment is pretty high.
作者
黄正义
赵增霞
叶佳媚
HUANG Zhengyi;ZHAO Zengxia;YE Jiamei(Department of Emergency,Central Hospital of Longhua District,Shenzhen,Guangdong 518000,China;Department of Neurology,Central Hospital of Longhua District,Shenzhen,Guangdong 518000;Department of Neurology,the First People′s Hospital,Taizhou,Zhejiang 318020,China)
出处
《重庆医学》
CAS
2020年第23期3979-3984,共6页
Chongqing medicine
关键词
脑小血管病
磁共振成像
认知功能损伤
危险因素
LOGISTIC模型
预测
cerebral small vessel disease
magnetic resonance imaging
total cerebral small vessel disease score
cognitive dysfunction
risk factors
Logistic models
forecasting
