Study On The Correlation Between Vascular Cognitive Impairment Not Dementia (Spleen And Kidney Deficiency,Phlegm Blind Orifices) And Homocysteine

Objective:To investigate the relationship between patients with non-dementia vascular cognitive impairment(spleen and kidney deficiency,phlegmand blood stasis syndrome)and homocysteine.Methods:Using the cross-sectional survey method,106 patients(55.79%)were enrolled in the VCIND(spleen and kidney deficiency,phlegmand phlegm and phlegm syndrome)and 84(44.21%)in the normal cognitive group.The results of general information,bad habits,and disease history of the included patients were counted.The χ2test and binary logistic regression were used to analyze the correlation between non-dementia-type vascular cognitive impairment and various related factors.The biased score matching method was used to balance the bias of the mixed factors between the two groups.After matching,if there is a difference in the outcome of the two groups,it can be completely attributed to the role of plasma homocysteine.The diagnostic value of plasma homocysteine for non-dementia-type vascular cognitive impairment was analyzed by experimental diagnosis and ROC curve.Results: 1.According to the χ2 test,there was no significant difference between the pre-match gender,education level and drinking(P>0.05),indicating that there was no difference between the two groups;age,smoking,hypertension,dyslipidemia,diabetes and hyperuricemia in the two groups.There was statistical significance(P<0.05),and there were differences between the two groups.At this point,the patient’s baseline data is not balanced,and a propensity score matching is needed to avoid the bias of the confounding factors on the results.2.Binary logistic regression analysis showed that the independent risk factors for non-dementia-type vascular cognitive impairment were age(OR=2.281,95% CI:1.098-4.739,P<0.05),hypertension(OR=2.087,95%).CI: 1.034-4.214,P<0.05),dyslipidemia(OR=2.054,95% CI: 1.026-4.112,P<0.05),diabetes(OR=2.478,95% CI:1.210-5.073,P<0.05)and Hyperuricemia(OR=3.637,95% CI: 1.776-7.449,P<0.05);hyperhomocysteinemia(OR=3.075,95% CI: 1.907-8.287,P<0.05);The OR value of homocysteine and hyperuricemia is relatively large,so it can be considered to have the greatest impact on non-dementia-type vascular cognitive impairment.3.The propensity score was successfully matched to 60 pairs of patients.After the χ2 test,there was no significant difference in gender,age,education level,smoking,alcohol consumption,hypertension,dyslipidemia,diabetes,and hyperuricemia between the two groups(P> 0.05),no difference between the two groups.Hyperhomocysteinemia was statistically significant(P<0.05),and there was a difference between the two groups,indicating that plasma homocysteine is associated with non-dementia-type vascular cognitive impairment.4.The area under the ROC curve for Hcy diagnosis of non-dementia-type vascular cognitive impairment was 0.633(95% CI 0.534-0.733;P<0.05),the optimal cut-off value was 23.4 μmmol/L,the sensitivity was 0.567,and the specificity was 0.700.Conclusion:Plasma homocysteine is an independent risk factor for non-dementia-type vascular cognitive impairment(spleen and kidney deficiency,phlegm and blood stasis syndrome),and has certain diagnostic value for VCIND.At the same time,age,hypertension,diabetes,dyslipidemia,and hyperuricemia are risk factors for VCIND,which may interact with hyperhomocysteinemia and have an effect on non-dementia-type vascular cognitive impairment.