摘要
目的观察老年(年龄≥60岁)脑小血管病(CSVD)患者运动障碍危险因素及其与运动障碍的相关性。方法回顾性分析116例临床诊断CSVD老年患者临床资料、基于头部MRI的影像学总负荷评分及实验室指标,以Tinetti平衡与步态量表(POMA)评估患者移动及平衡能力,将POMA评分≤24分者纳入运动障碍组、>24分者纳入非运动障碍组。以单因素分析及二元logistic回归分析观察CSVD患者运动障碍的危险因素,分析运动障碍者POMA评分与影像学总负荷评分及实验室指标的相关性。结果116例中,POMA评分<19分14例、19~24分35例、>24分67例。运动障碍组49例,非运动障碍组67例;组间血清同型半胱氨酸(Hcy)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血清缺血修饰清蛋白(IMA)、脂蛋白磷脂酶A2(Lp-PLA2)、脑源性神经营养因子(BDNF)水平及影像总负荷评分及POMA评分差异均有统计学意义(P均<0.05)。血清Hcy、NGAL、IMA、Lp-PLA2、BDNF水平及影像学总负荷评分均为CSVD患者发生运动障碍的独立危险因素(P均<0.05)。CSVD运动障碍患者POMA评分与血清Hcy、NGAL、IMA、Lp-PLA2水平及影像学总负荷评分均呈负相关(r s=-0.60、-0.48、-0.69、-0.65、-0.72,P均<0.05),与血清BDNF水平呈正相关(r s=0.63,P<0.05)。结论与POMA评分存在相关性的血清Hcy、NGAL、IMA、Lp-PLA2、BDNF水平及影像学总负荷评分均为老年CSVD患者发生运动障碍的独立危险因素。
Objective To explore the risk factors of dyskinesia and correlations with dyskinesia in elderly(age≥60 years)patients with cerebral small-vessel disease(CSVD).Methods Clinical data,total imaging load score based on head MRI and laboratory indicators of 116 elderly patients with clinically diagnosed CSVD were retrospectively analyzed.Tinetti performance oriented mobility assessment(POMA)was used to assess patients'movement and balance ability,and patients with POMA≤24 points were divided into dyskinesia group,while with POMA>24 points were divided into non-dyskinesia group.Univariate analysis and binary logistic regression were used to analyze the risk factors of dyskinesia in CSVD patients.The correlations of POMA score with total imaging load score and laboratory indicators in CSVD patients with dyskinesia were analyzed.Results Among 116 patients,14 were found with POMA<19 points,35 with POMA 19—24 points and 67 cases with POMA>24 points.There were 49 patients in dyskinesia group and 67 in non-dyskinesia group.Significant differences of serum homocysteine(Hcy),neutrophil gelatinase-associated lipocalin(NGAL),ischemia-modified albumin(IMA),lipoprotein phospholipase A2(Lp-PLA2),brain-derived neurotrophic factor(BDNF),total imaging load score and POMA score were found between groups(all P<0.05).Serum Hcy,NGAL,IMA,Lp-PLA2,BDNF and total imaging load score were all independent risk factors of dyskinesia in CSVD patients(all P<0.05).POMA score of CSVD patients with dyskinesia was negatively correlated with serum Hcy,NGAL,IMA,Lp-PLA2 levels and total imaging load score(r s=-0.60,-0.48,-0.69,-0.65,-0.72,all P<0.05)but positively correlated with serum BDNF level(r s=0.63,P<0.05).Conclusion Being correlated with POMA score,serum Hcy,NGAL,IMA,Lp-PLA2,BDNF and total imaging load score were independent risk factors of dyskinesia in elderly patients with CSVD.
作者
代博
万亚存
王润润
DAI Bo;WAN Yacun;WANG Runrun(Department of Medical Imaging,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Clinical Medicine,Zhengzhou Shuqing Medical College,Zhengzhou 450064,China;Department of Neurology,Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《中国医学影像技术》
CSCD
北大核心
2022年第12期1802-1806,共5页
Chinese Journal of Medical Imaging Technology
基金
河南省医学科技攻关计划项目(SBGJ202103008)。
关键词
老年人
脑血管疾病
运动障碍
影像学总负荷评分
aged
cerebrovascular disorders
movement disorders
total imaging load score
