颈动脉内膜-中层厚度、血清超敏C反应蛋白水平与老年人认知功能障碍的相关性研究

摘要

目的：探讨颈动脉内膜-中层厚度（IMT）、超敏C反应蛋白（hs-CRP）与老年人认知功能障碍的相关性。方法对899名老年人，采用简易精神状态检查（ MMSE）量表检测认知功能，颈动脉超声测量颈动脉IMT，并检测血清hs-CRP水平，进行比较分析。结果 MMSE筛查出认知功能障碍者260例（认知障碍组），无认知功能障碍者639例（对照组）。认知障碍组颈动脉IMT增厚的比率（49．2％）明显高于对照组（35．8％），（P＜0.05），认知障碍组hs-CRP水平增高的比率（28．1％）显著高于对照组（15．0％），（P＜0.05）；与hs-CRP＜5 mg／L、IMT正常者比较，单纯IMT增厚或单纯hs-CRP≥5 mg／L者发生认知功能障碍的风险分别为1．492倍、1．638倍（OR＝1．492，95％CI：1．066～2．088；OR＝1．638，95％CI：1．017～2．638，all P＜0.05）， hs-CRP≥5 mg／L同时颈动脉IMT增厚者发生认知功能障碍的风险为4．849倍（ OR＝4．849，95％CI：2．868～8．199，P＜0.01），大于单纯hs-CRP≥5 mg／L和单纯颈动脉IMT增厚的危险性之和。结论颈动脉IMT增厚、hs-CRP水平增高是老年人认知功能障碍的独立危险因素，hs-CRP水平增高同时IMT增厚对老年人认知功能障碍的发生有协同作用。%Objective To investigate the relationship among carotid artery intima media thickness ( IMT ) , serum lever of high sensitivity C-reactive protein ( hs-CRP) and cognitive impairment in elderly people .Methods In a total of 899 elderly people, whose cognitive function were examed by the Mini-Mental State Examination(MMSE), the carotid artery IMT were measured by carotid artery ultrasound , and the serum lever of hs-CRP were detected .The results were compared and analyzed .Results MMSE showed that 260 subjects with cognitive impairment were defined as cognitive dysfunction group , 639 subjects without cognitive impairment were defined as control group .In the cognitive dysfunction group , the incidence of carotid artery IMT thickening was significantly higher than those in the control group(49.2% and 35.8%, P<0.05);and hs-CRP levels were significantly higher than those in the control group(28.1%and 15.0%,P<0.05).Compared with hs-CRP <5 mg/L and IMT normal people, the risk of cognitive dysfunction in only hs-CRP≥5 mg/L or only IMT thickening people were 1.492 times, 1.638 times ( OR=1.492,95%CI:1.066-2.088;OR=1.638,95%CI:1.017-2.638,all P<0.05);the risk of cognitive dysfunction in hs-CRP≥5 mg/L with IMT thickening people were 4.849 times(OR=4.849,95%CI:2.868-8.199,P<0.01), more than the sum of risk value in only hs-CRP≥5 mg/L and only IMT thickening .Conclusions Carotid IMT thickening and hs-CRP levels increase are the independent risk factors with cognitive impairment in elderly people , and these two act synergistically for the risk of incidences of cognitive impairment .