血清尿酸水平在血管性痴呆中的风险预测

Predictive value of serum uric acid level in risk for vascular dementia

摘要:

目的 评估血清尿酸水平对血管性痴呆的预测价值。方法 回顾性选取2020年6月至2021年5月上海市杨浦区控江社区卫生服务中心收治的血管性痴呆患者47例(观察组)和同期健康志愿者46名(对照组)。血管痴呆的严重程度通过临床痴呆评定量表(CDR)进行评定。采用SPSS 24.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。采用二元logistic回归分析法分析患者血管性痴呆的危险因素,通过Spearman 相关性分析测定血清尿酸水平与CDR评分的相关性。采用受试者工作特征(ROC)曲线分析血清尿酸水平对血管性痴呆的预测价值。结果 与对照组比较,观察组患者的血清尿酸水平显著增高[(314.03±118.49)和(228.20±65.24)mmol/L, P<0.01]。血清尿酸水平与CDR评分呈正相关(r=0.797, P<0.01)。患者血清尿酸水平(OR=1.025,P=0.000,95%CI 1.014~1.036)和颈总动脉内膜中层的厚度 (OR=0.055,P=0.003,95%CI 0.008~0.369)是影响患者血管性痴呆的危险因素。血清尿酸对血管性痴呆具有一定的预测价值,ROC曲线下面积为0.768,最佳截断点为284.52mmol/L,灵敏度为53.29%,特异度为91.31%。结论 血清尿酸水平可作为血管性痴呆的预测指标,且与血管性痴呆的严重程度正相关。

Abstract:

Objective To evaluate the predictive value of serum uric acid level for vascular dementia. Methods A total of 47 patients with vascular dementia treated in our health service center from June 2020 to May 2021 were enrolled in this retrospective study and assigned into the observation group, and another 46 healthy volunteers subjected during the same period served as control group. The severity of dementia was assessed with the clinical dementia rating (CDR) scale. SPSS statistics 24.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison depending on different data types. Binary logistic regression analysis was adopted to analyze the risk factors of vascular dementia, and Spearman correlation analysis was performed to analyze the correlation of serum uric acid level and CDR score. Receiver operating characteristic (ROC) curve was drawn to assess the predictive value of the serum uric acid level for vascular dementia. Results The serum uric acid level was significantly higher in the observation group than the control group [(314.03±118.49) vs (228.20±65.24)mmol/L; P<0.01]. Serum uric acid level was positively correlated with CDR score (r=0.797, P<0.01). Serum uric acid level (OR=1.025, P=0.000,95%CI 1.014-1.036) and carotid intima media thickness (OR=0.055, P=0.003,95%CI 0.008-0.369) were risk factors for vascular dementia. ROC curve analysis revealed that the serum uric acid level (cut-off value=284.52 mmol/L, sensitivity=53.29%, specificity=91.31%) was a predictor of vascular dementia with an area under the curve of 0.768. Conclusion Serum uric acid level can be used as a predicative indicator for vascular dementia, and is positively correlated with its severity.