血清维生素及海马体积与卒中后认知障碍的相关性
钱 来 秦若梦 赵 辉
南京大学医学院附属鼓楼医院，江苏 南京 210008
通信作者：钱来
【摘要】 目的 探讨卒中后认知障碍（PSCI）患者血清维生素水平、海马体积与认知域的相关性。方法 纳入南京大学医学院附属鼓楼医院神经内科的 55 例脑卒中患者，其中认知正常（NC 组）24 例和 PSCI（PSCI 组）31 例。检测血清维生素水平，采用认知量表评估认知域，高分辨磁共振评估海马体积。结果 相对于 NC 组，PSCI 组在语言、执行功能、注意力及视空间能力方面表现更差。PSCI 组血清 25-羟基维生素D［（33.77±13.41）μg/L］水平显著低于NC组［（61.47±20.89）μg/L］，血清维生素B2［（9.18±4.85）μg/L］水平显著低于 NC 组［（17.18±4.53）μg/L］，血清维生素 B6［（10.16±4.87）μg/L］水平显著低于 NC 组［（20.17±8.67）μg/L］，血 清 维 生 素 B12 水 平［（308.22±173.26）ng/L］显 著 低 于 NC 组［（796.07±339.46）ng/L］。Pearson 相关性分析提示，血清维生素 B2水平与语言功能显著相关（r=0.426，P=0.001），血清维生素 B6水平与记忆（r=0.331，P=0.014）、语言（r=0.326，P=0.007）、执行（r=-0.431，P=0.001）和视空间（r=0.291，P=0.031）功能显著相关，血清维生素 B12水平与记忆（r=0.326，P=0.015）、语言（r=0.398，P=0.003）和执行（r=-0.332，P=0.013）功能显著相关，左侧海马体积与记忆（r=0.288，P=0.033）和语言（r=0.296，P=0.028）功能显著相关。多元线性回归分析表明，左侧海马体积可能是记忆功能的预测指标（β=0.606，P=0.021），血清维生素B2水平可能是语言功能的预测指标β=0.350，P=0.013），血清维生素 B6水平可能是执行功能的预测指标（β=-0.379，P=0.025）。结论 PSCI 患者左侧海马体积可能是记忆功能的预测指标，血清维生素 B2水平可能是语言功能的预测指标，血清维生素 B6水平可能是执行功能的预测指标。
【关键词】 卒中后认知障碍；维生素；海马体积；认知域；相关性；血清
【中图分类号】 R749.1+ 3 【文献标识码】 A 【文章编号】 1673-5110 （2022） 05-0529-05
基金项目：国家自然科学基金 （编号：81771157）
DOI：10.12083/SYSJ.220305
Correlation of serum vitamin，hippocampal volume and cognitive domain in patients of post stroke cognitive impairment
QIAN Lai，QIN Ruomeng，ZHAO Hui
Affiliated Drum Tower Hospital of Nanjing University Medical School，Nanjing 210008，China
Corresponding author：QIAN Lai
【Abstract】 Objective To investigate the correlation between serum vitamin，hippocampal volume and cognitive domain in patients with post stroke cognitive impairment（PSCI）. Methods Fifty-five cases from the Department of Neurology，Affiliated Drum Tower Hospital of Nanjing University Medical School，including 24 cases were cognitively normal（NC group）and 31 cases were PSCI（PSCI group）. Serum vitamin levels were detected. Neuropsychology was used to evaluate the cognitive domain and high resolution magnetic resonance was used to evaluate hippocampal volume. Results Compared with NC group，PSCI group performed worse in language，executive function，attention and visuospatial ability. The level of 25-hydroxyvitamin D in PSCI group（（33.77±13.41）μg/L）was significantly lower than that in NC group（（61.47±20.89）μg/L）. The level of serum vitamin B2 in PSCI group（（9.18±4.85）μg/L）was significantly lower than that in NC group（（17.18±4.53）μg/L）. The level of serum vitamin B6 in PSCI group（（10.16±4.87）μg/L）was significantly lower than that in NC group（（20.17±8.67） μg/L）. The serum vitamin B12 level in PSCI group（（308.22±173.26）ng/L）was significantly lower than that in NC group（（796.07±339.46）ng/L）. Correlation analysis showed that serum vitamin B2 level was significantly correlated with language function（r=0.426，P=0.001），serum vitamin B6 level was significantly correlated with memory（r=0.331，P=0.014），language（r=0.326，P=0.007），executive（r=-0.431，P=0.001）and visuospatial ability（r=0.291，P=0.031），serum vitamin B12 level was significantly correlated with memory（r=0.326，P=0.015），language（r=0.398，P=0.003）and executive function（r=-0.332，P=0.013），and left hippocampus volume was significantly correlated with memory（r=0.288，P=0.033）and language function（r=0.296，P=0.028）. Multiple linear regression analysis suggested that left hippocampus volume may be a predictor of memory function（β=0.606，P= 0.021），serum vitamin B2 level may be a predictor of language function（β=0.350，P=0.013），and serum vitamin B6 level may be a predictor of executive function（β=-0.379，P=0.025）. Conclusion In PSCI patients，left hippocampus volume may be a predictor of memory function，serum vitamin B2 level may be a predictor of language function，and serum vitamin B6 level may be a predictor of executive function.
【Key words】 Post stroke cognitive impairment; Vitamin; Hippocampal volume; Cognitive domain; Correlation；Serum
