Stroke:缺血性脑卒中患者高敏心肌肌钙蛋白T与认知功能的关系

2020-04-13 MedSci原创 MedSci原创

在无痴呆的轻度至中度缺血性卒中患者中,较高的hs-cTnT与基线时较高的认知障碍患病率和3年随访期间较低的认知状态改善相关。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在评估高敏感心肌肌钙蛋白T (hs-cTnT),一种心肌损伤的特异性生物标志物,是否与首次轻度至中度缺血性卒中患者的认知功能相关。

研究人员使用的数据来自柏林卒中前瞻性队列(PROSIS-B)。在基线时通过Mini心理状态检查对认知功能进行评估,并在1至3年的随访后进行认知状态修正的电话访谈。患者按hs-cTnT的四分位数水平进行分类。研究人员进行了广义线性回归来计算认知障碍的风险比(Mini心理状态测试评分<27;认知状态修正的电话访谈评分<32)。研究人员使用线性混合模型估计hs-cTnT与认知功能随时间的相关性。

研究人员纳入了555名患者(平均年龄为67岁,62%为男性,美国国立卫生研究院卒中量表得分中位数为2[四分位数范围为1-5],hs-cTnT高于参考上限占40%,基线认知障碍占28%)。hs-cTnT最高四分位数与最低四分位数的患者相比,基线Mini精神状态评估分数和认知障碍发生率较低(中位数为27 vs. 29和15.3% vs. 43.0%,调整风险比为1.76[95%CI为1.07-2.90])。如果有什么区别的话,似乎所有组的患者认知功能均有改善,然而hs-cTnT最高四分位数与最低四分位数患者相比,电话采访中认知状态修正评分持续降低(调整β为-1.33(95%可信区间为-2.65至-0.02),而随时间变化的发生率没有差异。

由此可见,在无痴呆的轻度至中度缺血性卒中患者中,较高的hs-cTnT与基线时较高的认知障碍患病率和3年随访期间较低的认知状态改善相关。

原始出处:

Leonie H.A. Broersen.et al.High-Sensitivity Cardiac Troponin T and Cognitive Function in Patients With Ischemic Stroke.stroke.2020.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.028410

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    2020-04-13 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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