脑梗死患者认知功能障碍与高半胱氨酸及类胰岛素样生长因子-1的相关性分析

摘要

目的 探讨脑梗死患者认知功能障碍与高半胱氨酸(tHcy)及类胰岛素样生长因子-1(IGF-1)的相关性.方法 选取我院98例脑梗死患者及同期45例健康体检者作为观察对象,比较脑梗死组与健康体检组血清tHcy、IGF-1浓度.根据蒙特利尔认知评估量表(MoCA)评分结果将脑梗死患者分为认知功能障碍组42例和认知功能正常组56例,比较两组患者血清tHcy、IGF-1浓度.以tHcy、IGF-1作为脑梗死后认知功能障碍的潜在危险因素,进行Logistic多因素回归分析.结果 脑梗死组血清tHcy浓度显著高于健康体检组,血清IGF-1浓度显著低于健康体检组(P＜0.05).认知功能障碍组血清tHcy浓度显著高于认知功能正常组,血清IGF-1浓度显著低于认知功能正常组(P＜0.05).高血清tHcy浓度、低血清IGF-1浓度为脑梗死后认知功能障碍的独立危险因素.结论 脑梗死患者存在高水平的血清tHcy及低水平的血清IGF-1,脑梗死后认知功能障碍的发生与tHcy、IGF-1密切相关,高血清tHcy浓度、低血清IGF-1浓度可显著增大脑梗死后并发认知功能障碍的风险.%Objective To investigate the correlation between total homocysteine (tHcy),insulin-like growth factor-1 (IGF-1)and mild cognitive impairment in stroke patients.Methods Ninety-eight stoke patients and 45 healthy people were selected as subjects for this study.The serum levels of tHcy and IGF-1 were measured.According to the MoCA scores,the stroke patients were divided into cognitive impairment group (n =42) and the cognitive normal group (n =56).Serum levels of tHcy and IGF-1 levels were compared between the two groups.Logistic analysis of multi-factor regression was used to evaluate the relationship of tHcy and IGF-1 with mild cognitive impairment after stroke.Results The serum level of tHcy was higher and the IGF-1 level was lower in the stroke patients than those in the controls (P ＜ 0.05).The tHcy level was higher and IGF-1 level was lower in the cognitive impairment group than those in the cognitive normal group,while the than that in cognitive normal group (P ＜ 0.05).Logistic analysis of multi-factor regression showed that the high tHcy level and low IGF-1 level were independent risk factors for mild cognitive impairment after stroke.Conclusion There is high tHcy level and low IGF-1 level in stroke patients.The mild cognitive impairment after stroke is related with tHcy and IGF-1 levels.The high tHcy level and low IGF-1 level might be risk factors for mild cognitive impairment after stroke.