肖婷 黄小红

【摘要】 目的：探討糖化血红蛋白（HbA1c）、纤维蛋白原（FIB）水平与急性脑梗死（ACI）老年患者认知功能的相关性。方法：选择本院2018年1月-2021年5月收治的94例ACI老年患者，按蒙特利尔认知评估量表（MoCA）将患者分为两组，其中49例认知功能障碍患者设为A组，45例认知正常患者设为B组。比较两组MoCA评分和HbA1c、FIB水平差异，并分析HbA1c、FIB与ACI老年患者认知功能之间的关系。结果：A组延迟回忆、视空间与执行能力、注意和计算力、命名、语言功能、定向力、抽象思维能力评分和MoCA总分均低于B组，HbA1c、FIB水平均高于B组，差异均有统计学意义（P<0.05）;HbA1c、FIB水平与ACI老年患者延迟回忆、视空间与执行能力、注意和计算力、语言功能、命名评分和MoCA总分均呈负相关（P<0.05），与定向力、抽象思维能力无相关性（P>0.05）。结论：HbA1c、FIB水平与ACI老年患者认知功能密切相关，为临床治疗提供新的思路。

【关键词】 急性脑梗死 糖化血红蛋白 认知功能 纤维蛋白原

Correlation of Glycosylated Hemoglobin and Fibrinogen Levels with Cognitive Function in Elderly Patients with Acute Cerebral Infarction/XIAO Ting， HUANG Xiaohong. //Medical Innovation of China， 2021， 18（34）： -142

[Abstract] Objective： To investigate the correlation of glycosylated hemoglobin （HbA1c） and fibrinogen （FIB） levels with cognitive function in elderly patients with acute cerebral infarction （ACI）. Method： A total of 94 elderly patients with ACI admitted to our hospital from January 2018 to May 2021 were selected and divided into two groups according to the Montreal cognitive assessment scale （MoCA）. Among them， 49 patients with cognitive impairment were assigned to group A and 45 patients with cognitive normal were assigned to group B. The differences of MoCA score， HbA1c and FIB levels between the two groups were compared， and the relationship between HbA1c， FIB and cognitive function of elderly ACI patients was analyzed. Result： Delayed recall， visuospatial and executive ability， attention and computation， naming， language function， orientation， abstract thinking ability scores and MoCA total score in group A were lower than those in group B， HbA1c and FIB levels in group A were higher than those in group B， and the differences were statistically significant （P<0.05）; HbA1c and FIB levels were negatively correlated with delayed recall， visual space and executive ability， attention and computation ability， language function， naming scores and MoCA total score in elderly ACI patients （P<0.05）， but not with orientation and abstract thinking ability （P>0.05）. Conclusion： HbA1c and FIB levels are closely related to cognitive function in elderly ACI patients， providing new ideas for clinical treatment.

[Key words] Acute cerebral infarction Glycosylated hemoglobin Cognitive function Fibrinogen

First-author’s address： Jiujiang First People’s Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.34.033

急性脑梗死（ACI）好发于老年人群，是由脑组织血供障碍造成脑组织发生缺血缺氧性坏死所致，具有发病急骤、致残率高、病情进展迅速、致死率高等特点，若不及时治疗，可能会引起认知功能、记忆功能障碍和偏瘫等并发症[1-2]。其中认知功能障碍可致患者出现概念模糊、注意力不集中、信息处理速度减慢等表现，若不及时治疗，易引起终生性认知功能障碍疾病，增加家庭精神负担与经济负担[3-4]。糖化血红蛋白（HbA1c）是可持续存在于红细胞生命周期内的红细胞内蛋白，合成速率与血糖水平呈正相关，能准确反映血糖水平;纤维蛋白原（FIB）是机体出现继发性纤溶和高凝状态的分子标志物，研究发现，两者异常变化与认知功能存在密切关系[5-6]。……