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投稿时间：2024-07-11 网络发布日期：2025-08-20
投稿时间：2024-07-11 网络发布日期：2025-08-20
中文摘要: 目的 探讨继发认知功能障碍的脑梗死患者早期蒙特利尔认知评估量表（MoCA）评分、血清S100蛋白、25-羟维生素D3［25（OH）D3］水平，并分析三者对脑梗死患者继发认知功能障碍的预测价值。方法 选取2023年3月至6月南通大学附属常熟医院收治的60例脑梗死患者为研究对象。对患者进行为期6个月的随访，根据是否继发认知功能障碍将患者分为发生组（26例）和未发生组（34例）。对比两组早期MoCA评分以及血清C反应蛋白（CRP）、同型半胱氨酸（Hcy）、血肌酐（Scr）、S100蛋白、25（OH）D3水平，使用多因素logistic回归分析脑梗死患者继发认知功能障碍的影响因素，并使用受试者工作特征曲线（ROC）分析各指标对认知功能障碍的预测价值。结果 与未发生组相比，发生组患者血清 S100 蛋白水平较高［（0.62±0.16）μg/L vs（0.41±0.10）μg/L，t=6.233, P＜0.01］，25（OH）D3水平较低［（13.73±2.12）ng/mL vs（18.34±2.36）ng/mL，t=7.831，P＜0.01］。多因素logistic回归分析结果显示，高水平的血清S100蛋白、CRP、Hcy以及病灶部位在功能区是脑梗死患者继发认知功能障碍的危险因素，早期 MoCA 评分高、高 25（OH）D3 水平是脑梗死患者继发认知功能障碍的保护因素（P<0.05）。ROC曲线分析结果显示，三项指标单一及联合检测中，联合检测曲线下面积（AUC）、特异度和灵敏度最高。结论 早期MoCA评分、CRP、Hcy、S100蛋白、25（OH）D3与脑梗死患者继发认知功能障碍有关，早期MoCA评分联合血清S100蛋白、25（OH）D3检测对脑梗死患者继发认知功能障碍具有一定的预测价值。
Abstract:Objective To explore the early Montreal Cognitive Assessment（MoCA）score and serum levels of S100 protein and 25 - hydroxyvitamin D3［25（OH）D3］in patients with cerebral infarction who had secondary cognitive dysfunction，and to analyze the predictive value of these three factors for secondary cognitive dysfunction in patients with cerebral infarction. Methods A total of 60 patients with cerebral infarction treated at Affiliated Changshu Hospital of Nantong University from March to June 2023 were selected. Patients were followed for 6 months and divided into two groups based on the presence of secondary cognitive dysfunction：the occurrence group（26 cases）and the non -occurrence group（34 cases）. Early MoCA scores，serum levels of S100 protein，25（OH）D3，C-reactive protein（CRP），homocysteine（Hcy），and serum creatinine（Scr）were compared between the two groups. Multivariate logistic regression analysis was conducted to determine the influencing factors of secondary cognitive dysfunction in patients with cerebral infarction，and receiver operating characteristic（ROC）curve analysis was performed to assess predictive value of each index for cognitive dysfunction. Results Compared with the non-occurrence group，patients in the occurrence group had higher level of serum S100 protein［（0.62±0.16）μg/L vs（0.41±0.10）μg/L，t=6.233，P<0.01］and lower level of 25（OH）D3［（13.73±2.12）ng/mL vs（18.34±2.36）ng/mL，t=7.831，P<0.01］. Multivariate logistic regression analysis showed that high levels of CRP，Hcy and S100 protein，and lesions located in functional areas were risk factors for secondary cognitive dysfunction in patients with cerebral infarction，while high early MoCA scores and high 25（OH）D3 levels were protective factors（P<0.05）. ROC curve analysis indicated that the area under curve（AUC），specificity，and sensitivity of the combined detection were the highest among the single and combined detection of the three indicators.Conclusion Early MoCA scores，CRP，Hcy，S100 protein，and 25（OH）D3 are associated with secondary cognitive dysfunction in patients with cerebral infarction. Early MoCA scores combined with serum S100 protein and 25（OH）D3 measurements have certain predictive value for secondary cognitive dysfunction in these patients.
keywords: Cerebral infarction Cognitive dysfunction Secondary Montreal cognitive assessment S100 protein 25-hydroxyvitamin D3
文章编号： 中图分类号：R743.3 文献标志码：A
基金项目:苏州市卫生健康委员会“科教兴卫”青年科技项目（KJXW2022066）；苏州科技发展计划面上项目（SYW2024049）
附件
| Author Name | Affiliation |
| CHEN Yan，LIU Hui，YAN Manyun，ZHUO Ziliang，ZHAO Zongbo | Department of Neurology,Affiliated Changshu Hospital of Nantong University,Suzhou,Jiangsu 215500,China |
引用文本：
陈燕，刘晖，严满云，卓子良，赵宗波.早期MoCA评分联合血清S100蛋白和25-羟维生素D3对脑梗死继发认知功能障碍的预测价值[J].中国临床研究,2025,38(8):1237-1241.
陈燕，刘晖，严满云，卓子良，赵宗波.早期MoCA评分联合血清S100蛋白和25-羟维生素D3对脑梗死继发认知功能障碍的预测价值[J].中国临床研究,2025,38(8):1237-1241.