Objective To investigate the correlation and predictors of plasma biochemical parameters and vascular cognitive impairment .Methods We selected 490 cases of patients with ischemic stroke survivors (without recurrence in three months ) and followed up for 3 years in our hospital from December 2013 to December 2016 ,The correlation between plasma biochemical index and vascular cognitive impairment patients were analyzed ,132 cases were diagnosed as vascular cognitive impairment (VCI) ac-cording to the diagnostic and Statistical Manual of mental disorders (IV DSMIV ) criteria ,358 cases were diagnosed as non-vascular cognitive impairment patients according to the Mini Mental State Scale (MMSE) ,all patients received National Institute of Health Stroke Scale (NIHSS) for clinical evaluation of neurologic function and activities of daily living table (ADL) for the abil-ity of daily life ,The blood plasma biochemical index ,6 items of blood coagulation and computed tomography [CT ] or magnetic resonance imaging[MRI] were detected after admission .Results In demographics factors analysis ,there were difference statisti-cally in clouding age ,smoking ,alcohol consumption ,high blood pressure between vascular cognitive impairment and normal cogni-tive groups .In plasma biochemical index analysis ,there were difference statistically in homocysteine [Hcy] and low-density lipo-protein [LDL] between vascular cognitive impairment and normal cognitive groups .In logistic regression analysis ,VCI was associ-ated with increased risk for age (OR0.43 ,95％ CI 0.25 to 0.726 ) ,smoking (OR0.63 ,95％ CI 0.14 to 0.289 ) ,drinking (OR5.567 ,95％ CI 1.128 to 25.43) ,high blood pressure (SBP acuity 160 MMH) (OR12.17 ,95％ CI 3.33 to 44.36) ,and ho-mocysteine (OR1.025 ,95％ CI 0.99 to 1.052) ,low density lipoprotein (OR0.873 ,95％ CI 0.6 to 1.271) .Conclusion Hyperho-mocysteinemia and high density lipoprotein can significantly affect vascular cognitive impairment ,and they are independent risk factors for VCI .The combination of the two can be used as an early predictor of vascular cognitive impairment .%目的 探讨血浆生化指标与血管认知障碍的相关性及预测指标.方法 蚌埠市第一人民医院选取2013-12—2016-12490例缺血卒中患者,3个月无复发,随诊3 a,观测血浆生化指标与血管性认知障碍的相关性,患者使用《精神障碍诊断与统计手册IV》(DSMIV)标准,132例诊断为血管认知障碍(vascular cognitive impairment,VCI),采用简易精神状态量表(MMSE)对认知障碍程度进行评估,358例为非血管认知障碍患者,所有患者应用美国国立卫生院神经功能缺损评分(National Institute of Health Stroke Scale,NIHSS)对神经功能进行临床评估,日常生活活动能力量表(ADL)对日常生活能力进行评估,所有患者入院后行血浆生化指标检测、血常规、凝血6项、头CT、MRI影像检查.结果 在人口特征因素分析中,在缺血性卒中患者血管认知障碍与认知正常组之间,年龄、吸烟、饮酒、高血压差异有统计学意义,在血浆生化指标分析中,高同型半胱氨酸、低密度脂蛋白在血管认知障碍与认知正常组之间差异有统计学意义;有意义指标用Logistic二分类回归分析血浆生化指标对血管认知障碍影响分析,年龄(OR0.43,95％CI为0.25～0.726)、吸烟(OR0.63,95％CI为0.14～0.289)、饮酒(OR5.567,95％CI为1.128～25.43)、高血压(SBP≥160 mmHg)(OR12.17,95％CI为3.33～44.36)、同型半胱氨酸(OR1.025,95％CI为0.99～1.052),低密度脂蛋白(OR0.873,95％C I为0.6～1.271),余指标差异无统计学意义.结论 高同型半胱氨酸血症和高密度脂蛋白血症对血管认知障碍有显著影响,可以作为独立危险因素,二者联合可以作为血管认知障碍的早期预测指标.
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