Relationship Between Serum Bilirubin And Fibrinogen Levels And Non-dementia With Vascular Cognitive Impairment

Objective To investigate the relationship between serum bilirubin and fibrinogen(FIB)concentrations and cognitive function in patients with vascular cognitive impairment with no dementia(VCIND).Look for the influencing factors of the development of VCIND,and provide evidence for early diagnosis and treatment and prevention.Methods 82 patients who underwent neurology from Anhui Provincial Hospital from February 2017 to December 2017 were enrolled in the VCIND group,aged 54-87 years;70 cases of patients with normal cognitive ability in the outpatient department and physical examination center of our hospital were collected as the control group,aged 55-82 years old;The basic clinical data of all enrollees were collected,and blood samples were collected on an empty stomach overnight for 10 hours to detect plasma fibrinogen,total bilirubin(TB),direct bilirubin(DBIL),and Indirect bilirubin(IBIL)concentration,and carry out routine and exclusive laboratory tests and imaging examinations;All the participants were included in the mini-mental state examination(MMSE),the Montreal cognitive assessment(MoCA),and the clinical dementia rating scale(CDR).Assessment of cognitive function.The changes of bilirubin and fibrinogen concentration and cognitive function were compared between the two groups.Pearson correlation analysis was used to compare the correlation between the two groups and cognitive scores.Logistic regression was used to analyze the influencing factors of VCIND.Results(1)The mean age of VCIND group(72.38±7.99)was higher than that of the control group(68.53±7.54),while the age of education(8.13±3.36)was lower than that of the control group(10.63±3.56).The difference was statistically significant(P <0.05).(2)The serum total bilirubin concentration in the VCIND group was(11.46±4.46)?mol/L lower than that in the control group(14.27±5.35)?mol/L,while the FIB concentration was(3.4±0.72)g/L compared with the control group(2.6±0.47)g/L was higher,the difference was statistically significant(P<0.05).(3)The VCIND scores of MMSE scores(25.40±2.33)and MoCA scores(22.40±2.08)were lower than those of the control group(28.44±1.11,27.44±1.04),and the differences were statistically significant(t=-8.368,P= 0.000;t =-10.644,P = 0.000).(4)Serum bilirubin concentration and MMSE score and MoCA score total score(r=0.271,P=0.042;r=0.341,P=0.009)and their sub-projects were visual space and executive function,attention,delayed recall and other scores.Positive correlation(r=0.322,P=0.024;r=0.232,P=0.034;r=0.307,P=0.005),there was no significant correlation with naming,language,abstract thinking and orientation(P>0.05).Plasma FIB level and MMSE score and MoCA total score(r=-0.538,P=0.001;r=-0.464,P=0.007)and visual space and executive function,attention,delayed recall,abstract thinking,etc.in subprojects The scores were negatively correlated(r=-0.321,P=0.013;r=-0.305,P=0.016;r=-0.376,P=0.003;r=-0.295,P=0.017).there was no significant correlation with naming,language and orientation(P>0.05).(5)Logistic regression analysis showed that after adjusting for multiple factors,the age and high fibrinogen levels were negatively correlated with cognitive function(?=0.115,P=0.001;?=2.818,P=0.000),high education.The degree and total bilirubin level were positively correlated with cognitive function(?=-0.281,P=0.000;?=-0.101,P=0.035).Conclusion The serum bilirubin concentration of VCIND patients decreased,which was positively correlated with cognitive function;Plasma FIB levels were elevated and negatively correlated with cognitive function.Higher age and fibrinogen levels are risk factors for VCIND,while higher levels of education and total bilirubin levels are protective factors.