【摘要】 目的 探索肌萎缩侧索硬化(ALS)患者认知损害与代谢指标的关系，以期提高ALS患者认知损害的早期干预率。方法 回顾性分析2022年7月—2024年3月在甘肃省人民医院门诊及住院部就诊的36例ALS患者的基本临床资料，收集血肌酐(Cr)、尿酸(UA)、肌酸激酶(CK)、总胆固醇(TC)、甘油三酯(TG)、高/低密度脂蛋白胆固醇(H/LDL-C)等代谢指标，采用Spearman、logistic回归对代谢指标与认知损伤的相关性进行分析。结果 对36例ALS患者使用简易精神状态检查表(MMSE)评估显示，20例伴发认知功能障碍，认知功能障碍的发生率为55.56%。与非认知障碍组比较，认知障碍组女性占比、ALS患者功能评分量表(ALSFRSr)评分、CK和LDL-C等指标均较高，教育程度及UA均较低，差异有统计学意义(P<0.05)。蒙特利尔认知评估量表(MoCA)评估显示，19例伴发认知功能障碍，认知功能障碍的发生率为52.78%。与非认知障碍组比较，认知障碍组女性占比、ALSFRSr评分、CK和LDL-C等指标均较高，教育程度及UA均较低，差异有统计学意义(P<0.05)。Logistic回归分析显示，女性、高ALSFRSr评分及低UA均为患者认知损害的主要危险因素(P<0.05)。结论 女性、ALSFRSr评分、血脂、延髓起病、教育水平及UA与ALS患者认知损害相关，对ALS患者应加强以上因素的关注并及时干预。更多还原

【Abstract】 Objective To explore the relationship between cognitive impairment and metabolic indicators in patients with amyotrophic lateral sclerosis(ALS) in order to improve the early intervention rate of cognitive impairment in ALS patients. Methods The basic clinical data of 36 ALS patients who visited the Outpatient and Inpatient Departments of Gansu Provincial People’s Hospital from July 2022 to March 2024 were collected. Metabolic indexes such as serum creatinine(Cr), uric acid(UA), creatine kinase(CK), total cholesterol(TC), triglycerides(TG), high/low-density lipoprotein cholesterol(H/LDL-C) were also collected. Spearman and logistic regression were used to analyze the correlation between metabolic indexes and cognitive impairment. Results Univariate analysis: among the 36 ALS patients, 20 patients had cognitive impairment after minimum mental state examination(MMSE) evaluation, and the incidence of cognitive impairment was 55.56%. Compared with the non-cognitively impaired group, the cognitively impaired group had a higher percentage of females, higher ALSFRSr scores, higher CK and LDL-C, and lower education and UA, with statistically significant differences(P<0.05). After Montreal cognitive assessment(MoCA) evaluation, 19 patients had cognitive impairment, and the incidence of cognitive impairment was 52.78%. Compared with the non-cognitively impaired group, the cognitively impaired group had a higher percentage of females, higher ALSFRSr scores, higher CK and LDL-C, and lower education and UA, and the differences were statistically significant(P<0.05). Logistic regression analysis showed that female, high ALSFRSr score, and low UA were the main risk factors for cognitive impairment in patients(P<0.05). Conclusion Female gender, ALSFRSr score, blood lipids, bulbar onset, education level and UA are associated with cognitive impairment in ALS patients. It is necessary to pay more attention to the above factors and intervene in time for ALS patients.更多还原