神经科重症病房老年脑卒中相关性肺炎患者认知功能障碍发病机制  

The mechanism of pathogenesis of cognition dysfunction in elderly stroke related pneumonia patients in neurological intensive care unit

作　　者：朱刚[1] 余成[2] 钟平[1] 汪国胜[1] 刘彬[1] 刘宝 马争飞[1] 

机构地区：[1]宿州市立医院神经重症监护室,安徽宿州230000 [2]海南省人民医院心脏外科 [3]安徽医科大学附属省立医院重症医学科

出　　处：《中国老年学杂志》2016年第10期2361-2363,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金项目(81270265)

摘　　要：目的探讨神经科重症病房老年脑卒中相关性肺炎患者认知功能障碍的发病机制。方法收集该院2014年1月至2015年6月在神经科重症病房诊治的老年脑卒中相关性肺炎认知功能障碍患者40例,以同期健康体检者40例为对照组,老年肺炎患者40例设为肺炎组。分析各组受试者认知功能评分及血清中Wnt/β-catenin通路蛋白及细胞凋亡蛋白和氧化还原酶类水平的变化。结果认知患者认知功能指标记忆能力评分、注意力评分和计算能力评分均明显下降(P<0.01),且血清中Wnt、APC、Axin及GSK-3β蛋白水平明显高于对照组和肺炎组受试者(P<0.01);同时,患者血清中天冬氨酸蛋白水解酶(Caspase)2、Caspase6、Bax和丙二醛(MDA)水平明显升高,而Bcl2、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSHpx)和过氧化氢酶(CAT)水平明显降低。结论神经科重症病房老年脑卒中相关性肺炎患者易发生认知功能障碍,且可能与激活的Wnt/β-catenin信号通路和细胞凋亡过程相关。Objective To investigate the mechanism of pathogenesis of cognition dysfunction in elderly stroke related pneumonia patients in neurological intensive care unit. Methods 40 cases of elderly stroke related pneumonia patients in neurological intensive care unit were enrolled in this study. The cognition functions of all the subjects were assayed by MMES table and the serum Wnt/β-catenin related proteins were detected by ELISA. 40 cases of healthy subjects and 40 cases of pneumonia patients at the same period were taken as control. Results The MMSE scores were interrupted greatly in elderly stroke related pneumonia patients. The serum levels of Wnt,APC,Axin and GSK-3 were increased greatly（P〈0.01 ）, and the expressions of Caspase2, Caspase6 and Bax were increased greatly（P〈0.01 ）. The serum levels of SOD, CAT, GSHpx were higher in elderly stroke related pneumonia patients （P〈0.05）. Conclusions Activated Wnt/β-catenin signaling pathway and apoptosis process are involved in the pathogenesis of elderly stroke related pneumonia patients in neurological intensive care unit.

关 键 词：认知功能障碍 脑卒中 肺炎 WNT/Β-CATENIN信号通路 细胞凋亡 

分 类 号：R74[医药卫生—神经病学与精神病学]