脑小血管病患者肾小球滤过率和微量白蛋白检测与认知功能的关系

Relationships of GFR and microalbuminuria with cognitive impairment in patients with cerebral small vessel disease

摘要:

探讨脑小血管病（CSVD）患者的肾小球滤过率（GFR）和尿微量白蛋白（mALB）水平与认知损害的关系。方法选取84 例CSVD 患者（CSVD 组）和50 例健康体检者（对照组）为研究对象，测定患者的生化指标和mALB，计算GFR，分析GFR 和mALB 与认知损害的相关性。结果CSVD 组的GFR、尿微量白蛋白阳性率与对照组比较，差异无统计学意义（p <0.05），CSVD 组的GFR 水平低于对照组，尿微量白蛋白水平则高于对照组；CSVD患者GFR阳性组的MoCA 评分低于GFR 阴性组，合并VCI 发生率则高于GFR 阴性组；CSVD患者尿微量白蛋白阳性组的MoCA 评分低于尿微量白蛋白阴性组，合并VCI 发生率则高于尿微量白蛋白阴性组。结论CSVD合并GFR及mALB水平异常的患者均存在不同程度认知功能障碍，GFR 及mALB水平异常可能参与CSVD 认知功能损害的发病过程，GFR 和mALB 的检测对于CSVD 合并认知功能损害的早期筛查具有重要意义。

Abstract:

To investigate the relationships of glomerular filtration rate (GFR) and the level of urinary microalbumin (mALB) with cognitive impairment in patients of cerebral small vessel disease (CSVD). Methods Eighty-four patients with CSVD and 50 cases of volunteers (control group) were included in the study.The level of mALB were determined and GFR was calculated in all patients, and the correlations of cognitive impairment with GFR and mALB were analyzed. Results The GFR in the CSVD patients was significantly lower than that in the control group, while the level of urine microalbumin was significantly higher than that in the control group (p < 0.05). The MoCA scores in the GFR-positive group of the CSVD patients were sig-nificantly lower than those in the GFR-negative group, the scores in the GFR-positive patients combined with VCI were significantly higher than those in the GFR-negative group (p < 0.05). The MoCA scores in the CSVD patients with positive microalbuminuria were significantly lower than those in the mALB-negative group, but the MoCA scores in the mALB-positive CSVD patients combined with VCI were significantly higher than those in the mALB-negative group (p < 0.05). Conclusions There are cognitive dysfunctions in CSVD patients with abnormal levels of GFR and mALB, and the abnormal levels of GFR and mALB might be involved in the pathogenesis of cognitive impairment in CSVD patients. The detection of GFR and mALB is significant in the early screening of CSVD combined with cognitive impairment.