阿尔茨海默病患者外周血炎症因子水平与认知功能的相关性研究  

Correlation between serum inflammatory factor levels and cognitive function in patients with Alzheimer's disease

作　　者：梁春荣[1] 刘雨辉 王叶冉[1] 曾凡[1] 王鑫[1] 曹红元[1] 易旭[1] 胥娟[1] 姚秀卿[1] 高长越[1] 张莉莉[1] 许志强[1] 王琳[1] 周华东[1] 王延江[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《解放军医学杂志》2014年第2期133-137,共5页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(30973144;81270423);重庆市杰出青年科学基金(CSTC 2010BA5004);中国博士后科学基金(2013T60955);重庆市博士后科研项目(Xm201342)~~

摘　　要：目的探讨阿尔茨海默病（AD）患者血清中炎症因子IL-6、IL-1β、TNF-α、IFN-γ水平及其与认知功能的相关性。方法纳入AD患者llo例，以及年龄、性别匹配的认知功能正常的对照人群120例。搜集受试者的一般资料和疾病信息。采用简易精神状态量表（MMsE）和临床痴呆评定量表（CDR）对受试者认知功能和日常行为能力进行评估。收集血清，采用ELISA法测定血清炎症因子IL-6、IL-1β、TNF-α和IFN-γ的浓度。比较两组血清炎症因子水平的差异，采用非条件logistic回归筛选AD可能的影响因素。以全部人群为研究对象，分析血清炎症因子水平与MMSE评分的相关性。以AD组为研究对象，分析患者血清炎症因子水平与cDR评分的相关性。结果AD组血清中IL-1β（秩均值129．46pg／m1vs102．70pg／ml，P=0．002）、IL-6（秩均值125．25pg／m1ps106．56pg／ml，P=0．033）水平显著高于对照组，但TNF-α（秩均值116．40pg／mlps114．67pg／ml，P=0．844）和IFN-γ（秩均值115．90pg／mlvs115．14pg／ml，P=0．931）水平与对照组相比差异无统计学意义。整体人群中，仅IL-1β水平与MMSE评分呈负相关（r=-0．184，p=0．007）。AD患者血清中各炎症因子水平与CDR评分无相关性。危险因素分析显示，IL-1β是罹患AD的危险因素（OR=1．018，95％CI1．005～1．030），受教育年限为保护性因素（OR=0．891，95％CI 0．834～0．953）。结论血清炎症因子水平与整体人群的认知功能相关，但与AD患者的痴呆严重度无明显相关性。[Abstract] Objective To investigate the serum levels of inflammatory cytokines IL-6, IL-1β, TNF-α and IFN-γ and explore the correlation between the inflammatory factor levels and the cognitive function in patients with Alzheimer＇s disease （ADJ. Methods One hundred and ten AD patients and 120 cognitively normal subjects were recruited in the present study. Serum levels of IL-6, IL-1β, TNF-α and IFN-γ were determined with enzyme-linked immunosorbent assay （ELISA）. Mini-Mental State Examination （MMSE） and Clinical Dementia Rating Scale （CDR） were used to assess the cognitive function and activities of day living of the subjects. Wilcoxon rank sum test was used to compare the inflammatory cytokine levels between AD patients and healthy controls. Non-conditional logistic regression model was used to screen the potential influence factors of AD. Partial correlation analysis was performed to study the correlation between inflammatory cytokine levels of all subjects and MMSE scores in the whole sample, and the correlation between the serum levels of inflammatory cytokines and CDR scores was examined in the AD cohort. Results The serum levels of IL-1β （129.46 vs 102.70, P=0.002） and IL-6 （125.25 vs 106.56, P=0.033） were significantly higher in AD patients than that of normal control, while the values of TNF-α （116.40 vs 114.67, P=0.844） and IFN-γ （115.90 vs 115.14, P=0.931） were not significantly different between the two groups. The serum levels of IL-1β was correlated with MMSE score （r=-0.184, P=0.007） in the whole sample. No significant correlation was observed between serum inflammatory factors and CDR scores in AD patients. IL-1β was identified as a risk factor （OR=1.018, 95%CI 1.005-1.030） and duration of receiving education as a protective factor （OR=0.891, 95%CI 0.834-0.953） for AD. Conclusion The serum levels of inflammatory factors may be correlated with the cognitive function but not with the severity of dementia in AD patients.

关 键 词：阿尔茨海默病 白细胞介素类 认知障碍 

分 类 号：R512.620.2[医药卫生—内科学]