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目的探讨血淀粉样蛋白A(SSA)水平与急性脑梗死后认知功能障碍的关系。方法对480例脑梗死患者进行蒙特利尔认知功能评估,依据评估结果分为无认知障碍组及认知障碍组。对潜在的认知功能危险因素进行统计分析,将有统计学意义的因素与MoCA评分进行多元线性回归分析。并对血SSA水平与脑梗死后认知功能障碍的相关性进行分析。结果性别、酗酒、糖尿病、糖尿病肾病、关键部位梗死、受教育程度和血SSA浓度在认知功能障碍组和非认知功能障碍组间具有统计学差异(P<0.05)。MoCA评分与血SSA水平呈负相关(r=-0.63,P<0.05),而与性别、糖尿病、糖尿病肾病、关键部位梗死、受教育程度呈正相关。ROC曲线分析结果显示,血清SSA阈值为0.9 mg/L时,曲线下面积为0.894。检测的敏感性和特异性分别为78.2%和66.7%。结论血SSA在认知功能障碍的预测中具有一定的临床应用价值。
Objective To investigate the relationship between serum amyloid A (SSA) levels and cognitive dysfunction after acute cerebral infarction. Methods A total of 480 cerebral infarction patients were assessed for cognitive function in Montreal. According to the assessment results, they were divided into no cognitive impairment group and cognitive impairment group. Statistical analysis was performed on potential risk factors of cognitive function, and multivariate linear regression analysis was performed between the statistically significant factors and MoCA score. The correlation between serum SSA levels and cognitive dysfunction after cerebral infarction was analyzed. Results Gender, alcoholism, diabetes mellitus, diabetic nephropathy, key infarction, education level and serum SSA concentration were significantly different between cognitive dysfunction group and non-cognitive dysfunction group (P <0.05). MoCA score was negatively correlated with serum SSA level (r = -0.63, P <0.05), but positively correlated with sex, diabetes mellitus, diabetic nephropathy, key infarction and education level. ROC curve analysis showed that the area under the curve was 0.894 when the serum SSA threshold was 0.9 mg / L. Sensitivity and specificity of detection were 78.2% and 66.7% respectively. Conclusion Blood SSA has some clinical value in the prediction of cognitive dysfunction.