血清25(OH)D、Hcy及血栓前状态分子标志物与老年高血压病人认知功能障碍的关系

doi:10.3969/j.issn.1003-9198.2024.07.008

摘要/Abstract

摘要： 目的探讨血清25-羟维生素D[25(OH)D]、同型半胱氨酸(Hcy)及血栓前状态分子标志物与老年高血压病人认知功能障碍的关系。方法回顾性分析2021年3月至2023年3月于我院确诊的100例老年高血压病人的临床资料,根据是否合并认知功能障碍分为认知障碍组(26例)与非认知障碍组(74例)。收集病人一般资料,检测病人25(OH)D、Hcy、纤维蛋白原(Fbg)、纤溶酶原激活物抑制剂-1(PAI-1)、血管性血友病因子(vWF)、血小板α颗粒膜蛋白-140(GMP-140)水平。采用多因素Logistic回归分析老年高血压病人认知功能障碍的影响因素;使用ROC曲线分析各指标的诊断效能。结果认知障碍组年龄、Hcy、Fbg、PAI-1、vWF、GMP-140水平显著高于非认知障碍组,25(OH)D水平显著低于非认知障碍组(P＜0.01)。多因素Logistic回归分析显示,年龄、25(OH)D、Hcy、Fbg、PAI-1、vWF、GMP-140是老年高血压病人认知功能障碍的影响因素(P＜0.05)。ROC曲线分析结果显示,25(OH)D、Hcy、Fbg、PAI-1、vWF、GMP-140预测老年高血压病人认知功能障碍的AUC分别为0.875、0.850、0.944、0.876、0.905、0.864。结论 25(OH)D、Hcy及Fbg、PAI-1、vWF、GMP-140水平与老年高血压病人认知功能障碍之间存在密切联系,是老年高血压病人认知功能障碍的风险预测因子。

关键词: 高血压, 认知功能障碍, 血栓前状态, 纤溶酶原激活物抑制剂-1, 血管性血友病因子

Abstract: Objective To investigate the relationship of serum 25-hydroxyvitamin D[25(OH)D], homocysteine(Hcy) and prethrombotic state molecular markers with cognitive impairment in the elderly patients with hypertension. Methods The clinical data of 100 elderly hypertensive patients in our hospital from March 2021 to March 2023 were retrospectively analyzed, and the patients were divided into the cognitive impairment group(n=26) and the non-cognitive impairment group(n=74) according to whether they presented with cognitive dysfunction. The general data of the patients were collected, and the levels of 25(OH)D, Hcy, fibrinogen(Fbg), plasminogen activator inhibitor-1(PAI-1), vascular willebrand factor(vWF) and granule membrane protein-140(GMP-140) were detected and compared between the two groups. The receiver operating characteristics (ROC) curve was used to analyze the diagnostic efficiency of each index. The influencing factors for cognitive impairment in the elderly hypertensive patients were analyzed by multivariate Logistic regression analysis. Results The levels of age, Hcy, Fbg, PAI-1, vWF and GMP-140 were significantly higher, and the level of 25(OH) D in the cognitive impairment group was significantly lower than those in the non-cognitive impairment group(P<0.01). Multiple Logistic regression analysis showed that 25(OH) D, Hcy, Fbg, PAI-1, vWF, GMP-140 were the influencing factors of cognitive dysfunction in the elderly patients with hypertension(P<0.05). ROC curve analysis showed that the areas under the curve(AUC) of 25(OH) D, Hcy, Fbg, PAI-1, vWF and GMP-140 in predict cognitive dysfunction in the elderly patients with hypertension was 0.875, 0.850, 0.944, 0.876, 0.905 and 0.864, respectively. Conclusions The levels of 25(OH) D, Hcy and Fbg, PAI-1, vWF, GMP-140 are closely related to cognitive dysfunction in the elderly hypertensive patients, and the above indicators can be used to predict cognitive dysfunction in the elderly hypertensive patients.

Key words: hypertension, cognitive dysfunction, prethrombotic state, plasminogen activator inhibitor-1, vascular willebrand factor

中图分类号:

R 544.1

罗星, 梁珍玲, 丁玲, 黄芳. 血清25(OH)D、Hcy及血栓前状态分子标志物与老年高血压病人认知功能障碍的关系[J]. 实用老年医学, 2024, 38(7): 679-682.

LUO Xing, LIANG Zhenling, DING Ling, HUANG Fang. Relationship of serum 25(OH) D, Hcy and prethrombotic state molecular markers with cognitive impairment in elderly patients with hypertension[J]. Practical Geriatrics, 2024, 38(7): 679-682.

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