| BackgroundWith the development of society,the increase of aging population and the development of medical imaging technology,more and more cerebral small vessel diseases（CSVD）have been diagnosed.Because of its serious harm to the health of the elderly,it has received attention.Cerebral small vessel disease（CSVD）can lead to cognitive impairment as the disease progresses,resulting in a decline in living ability and affecting people’s lives.Cerebral microbleeds（CMBs）refer to the rupture of small blood vessels and are a common clinical subtype of cerebral small vessel disease.High uric acid can induce oxidative stress and inflammatory response in vascular endothelial cells,which is a risk factor for the occurrence and development of vascular diseases.Whether there is a correlation between serum uric acid and cognitive dysfunction and cerebral microbleeds in patients with cerebral small vessel disease and the specific mechanism of its occurrence have not yet been clearly elucidated.ObjectiveTo explore the relationship between serum uric acid level and cognitive dysfunction in patients with CSVD,and the relationship between serum uric acid level and the severity of cerebral microbleed（CMBs）.To provide theoretical support data for the early screening,detection and treatment of cognitive dysfunction and cerebral microbleeds in patients with cerebral small vessel disease.MethodsA total of 100 patients with cerebral small vessel disease who were diagnosed and treated in the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from February 2019 to December 2020 were selected and signed informed consent.The cognitive function of CSVD was exaluated by the Mini-Mental State Examination（MMSE）.The patients with cerebral small vessel disease were divided into two groups according to the scoring results,cognitive dysfunction group（N=41）and cognitive function normal group（N=59）.The basic information of patients and the results of serum uric acid and blood fat were recorded.The cerebral microbleeds（Cerebral microbleeds,CMBs）were detected by 3.0 T magnetic resonance susceptibility-weighted imaging（SWI）sequence,and the severity of CMBs was assessed according to the number of CMBs microbleeds in patients with cerebral small vessel disease.The conditions are as follows: mild: 1-2 microbleeds（N=37）;moderate: 3-9 microbleeds（N=16）;severe: ≥10 microbleeds（N=12）.SPSS 22.0statistical software was used for data analysis,multivariate binary logistic regression was used to analyze the effect of serum uric acid level on the occurrence of cognitive dysfunction,and a working characteristic（ROC）curve was constructed to evaluate the diagnostic value of serum uric acid on cognitive dysfunction in patients with CSVD,area under the curve（AUC）,cutoff point,sensitivity,specificity,and Youden index were calculated.Logistic regression was sued to analyze the association between serum uric acid and the occurrence of CMBs,and ROC curve was performed to calculate the AUC,cutoff point,sensitivity,specificity,and Youden index;Spearman’s rank correlation method was used to analyze the correlation between serum uric acid and the severity of CMBs.ResultsThe age and serum uric acid of the cognitive dysfunction group were higher than those of the cognitive function normal group（P<0.05）.Logistic regression analysis showed that age（OR: 1.058,95% CI: 1.004-1.114,P=0.033）and serum uric acid（OR: 1.031,95%CI:1.017-1.045,P < 0.001）were independent risk factors for cognitive dysfunction in patients with cerebral small vessel disease.The ROC curve analysis showed that the area under the curve（AUC）of age-diagnosed CSVD patients with cognitive dysfunction was 0.656（95% CI:0.550-0.762;P=0.008）,the cutoff point was 61.5 years,sensitivity,specificity,and Youden index was 80.5%,54.2%,and 0.347,respectively.The AUC of serum uric acid for diagnosing cognitive dysfunction in patients with cerebral small vessel disease was 0.847（95% CI:0.770-0.925;P<0.001）,the cut off point was 271.5,sensitivity,specificity,and Youden index was 80.5%,78.0%,and 0.585,respectively,suggesting that age and serum uric acid had diagnostic value for cognitive dysfunction in cerebral small vessel disease.The concentrations of serum uric acid was higher in patients with CMBs than those without CMBs（P<0.05）.Results of Logistic regression showed that serum uric acid（OR: 1.019;95% CI:1.010-1.029,P<0.001）was a risk factor for CMBs among patients with CSVD.ROC curve showed that the AUC of serum uric acid for diagnosing CMBs in patients with cerebral small vessel disease was 0.782（95% CI: 0.691-0.874;P<0.001）,the cutoff point was 242,sensitivity,specificity,and Youden index was 80.0%,62.9%,and 0.429,respectively,suggesting that serum uric acid had diagnostic value for CMBs in cerebral small vessel disease.There were significant differences in the levels of serum uric acid between groups with different severity of CMBs（P<0.05）.The results of Spearman correlation analysis showed that serum uric acid（rs 0.579,P < 0.001）,the severity of CMBs and the level of serum uric acid were positively correlated（P<0.05）.ConclusionsSerum uric acid is associated with the occurrence of cognitive dysfunction in patients with cerebral small vessel disease,and has some predictive value for the diagnosis of cognitive dysfunction in cerebral small vessel disease.Serum uric acid is also positively correlated with the severity of cerebral microbleeds in patients with cerebral small vessel disease. |
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