摘要
目的分析神经营养相关因子水平对老年脑梗死后认知障碍的预测价值。方法回顾性分析2022年2月至2024年1月常州市武进中医医院收治的137例老年脑梗死患者的临床资料,发病7 d时,根据患者是否发生认知障碍分为发生组(n=49)与非发生组(n=88)。对比2组患者营养相关因子水平[脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)]及临床资料,筛查老年脑梗死患者发生认知障碍的影响因素,构建并验证老年脑梗死患者发生认知障碍的风险预测模型。结果发生组血清BDNF、GDNF水平低于非发生组(P<0.05)。发生组女性比例、美国国立卫生研究院脑卒中量表(NIHSS)评分、低密度脂蛋白胆固醇(LDL-C)水平高于非发生组(P<0.05)。Logistic回归分析结果显示,血清BDNF(OR=0.271,95%CI:0.128~0.662)、血清GDNF(OR=0.227,95%CI:0.100~0.516)、NIHSS评分(OR=4.768,95%CI:2.096~10.847)、LDL-C(OR=3.955,95%CI:1.749~8.997)为老年脑梗死患者发生认知障碍的影响因素(P<0.05)。列线图模型预测老年脑梗死患者发生认知障碍的灵敏度为79.6%(95%CI:65.2%~89.3%),特异度为90.9%(95%CI:82.4%~95.7%),曲线下面积为0.903(95%CI:0.821~0.965)。结论BDNF、GDNF水平与老年脑梗死患者发生认知障碍有关,以BDNF、GDNF、NIHSS评分和LDL-C构建的风险预测模型有助于预测老年脑梗死患者发生认知障碍风险。
Objective To analyze the predictive value of neurotrophic factors for cognitive impairment in the elderly after cerebral infarction.Methods The clinical data of 137 elderly patients with cerebral infarction who were admitted to Wujin Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were retrospectively analyzed.At 7 days after the onset of cerebral infarction,the patients were classified into occurrence group(n=49)and non‐occurrence group(n=88)according to the occurrence of cognitive impairment.The levels of nutrition‐related factors,such as brain‐derived neurotrophic factor(BDNF)and glial cell derived neurotrophic factor(GDNF),were compared between the two groups.The influencing factors of cognitive impairment in elderly patients with cerebral infarction were screened,and a risk prediction model for cognitive impairment in elderly patients with cerebral infarction was constructed and verified.Results The levels of serum BDNF and GDNF in the occurrence group were lower than those in the non‐occurrence group(P<0.05).The proportion of females,the National Institutes of Health stroke scale(NIHSS)score and the level of low‐density lipoprotein cholesterol(LDL‐C)in the occurrence group were higher than those in the non‐occurrence group(P<0.05).Logistic regression analysis showed that serum BDNF(OR=0.271,95%CI:0.128‐0.662),serum GDNF(OR=0.227,95%CI:0.100‐0.516),NIHSS score(OR=4.768,95%CI:2.096~10.847),and LDL‐C(OR=3.955,95%CI:1.749‐8.997)were the influential factors for cognitive impairment in elderly patients with cerebral infarction(P<0.05).The sensitivity,specificity and area under the curve of the nomogram model were 79.6%(95%CI:65.2%~89.3%),90.9%(95%CI:95%CI:82.4%~95.7%),and 0.903(95%CI:0.821‐0.965)for the prediction of cognitive impairment in elderly patients with cerebral infarction.Conclusion The levels of BDNF and GDNF are related to cognitive impairment in elderly patients with cerebral infarction.The risk prediction model constructed based on BDNF,GDNF,NIHSS score and LDL‐C can help to predict the risk of cognitive impairment in elderly patients with cerebral infarction.
作者
潘文洁
郭玲
Pan Wenjie;Guo Ling(Changzhou Wujin Hospital of Traditional Chinese Medicine,Changzhou 213161,China)
出处
《海军医学杂志》
2025年第7期728-732,共5页
Journal of Navy Medicine
基金
江苏省基础研究计划(自然科学基金)项目(BK20201095)。
关键词
脑源性神经营养因子
胶质细胞源性神经营养因子
老年
脑梗死
认知障碍
预测模型
Brain-derived neurotrophic factor
Glial cell derived neurotrophic factor
Elderly
Cerebral infarction
Cognitive impairment
Prediction model
作者简介
通信作者:郭玲,电子信箱:glbbz@163.com。
