急性颅脑损伤病人血清IGF-1动态变化与认知功能障碍的相关性研究  

Correlation study of the dynamic changes of serum insulin-like growth factor-1 and cognitive dysfunctions in patients with acute traumatic brain injury

作　　者：郭义君[1] 郑平[1] 童武松[1] 杨文进[1] 汪瑞忠[2] 焦荣红[2] 何斌[1] 匡助才[1] 吴晨星[1] 陈磊[1] 赵春芳[1] 倪萍[1] Guo Yijun Zheng Ping Tong Wusong Yang Wenjin Wang Ruizhong Jiao Ronghong He Binl Kuang Zhucail Wu Chenxing Chen Lei Zhao Chunfangl Ni Ping(Department of Neurosugery Department of Clinical Laboratory, People＇s Hospital of Pudong New District, Shanghai 201299, China)

机构地区：[1]上海市浦东新区人民医院神经外科,201299 [2]上海市浦东新区人民医院检验科,201299

出　　处：《中国微侵袭神经外科杂志》2017年第6期241-244,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：上海市卫计委科研课题基金项目(编号:201440067);上海市科委自然科学专项基金项目(编号:16ZR1431500);上海市浦东新区卫生系统重点专科建设专项基金项目(编号:PWZz2013-13)

摘　　要：目的探讨急性颅脑损伤(TBI)病人血清胰岛素样生长因子-1(IGF-1)动态变化与认知功能障碍的相关性。方法收集86例急性TBI病人作为研究组,分别于伤后1、3、5、7、14 d检测病人血清IGF-1含量,伤后6个月采用蒙特利尔认知评估量表(MoCA)评估有无认知功能障碍,并比较各时间点血清IGF-1含量与MoCA评分的相关性。选取30例同期健康体检者作为对照组。结果根据MoCA评分评估,TBI伤后6个月存在认知功能障碍36例(41.86%),主要表现为视空间与执行、注意力和计算力、语言能力、抽象能力及延迟记忆方面的障碍。研究组血清IGF-1含量在伤后各时间点均显著低于对照组(P<0.05)。伤后1、3、5 d,认知功能障碍病人血清IGF-1含量均显著低于无认知功能障碍病人(P<0.05)。伤后1、3、5 d,研究组病人血清IGF-1含量与MoCA评分呈正相关(P<0.05)。结论 TBI后血清IGF-1含量动态变化与认知功能障碍密切相关。伤后早期的血清IGF-1水平能够预测TBI病人的认知功能预后。Objective To investigate the correlations between dynamic changes of serum insulin-like growth factor -1 （IGF-1） and the cognitive dysfunction in acute traumatic brain injury （TBI）. Methods Eighty-six acute TBI patients were selected as study group and 30 healthy examinees at the same time were recruited as control group. The IGF-1 level was detected l, 3, 5, 7, 14 d after TBI and the cognitive dysfunction was evaluated based on Montreal congnitive assessment （MoCA） score 6 months after the injury, and Pearson correlation was performed between IGF-1 level and MoCA score. Results There were 36 TBI patients （41.86%） with cognitive dysfunction, who were assessed by MoCA scale. The main deficits contained visuospatial and executive functioning, attention and calculation, language, abstraction and delayed recall. The serum IGF- 1 level of TBI patients was significantly lower than that of the control group at all time points after TBI （P 〈 0.05）. The serum IGF-ls 1, 3, 5 d after TBI were significantly lower in the patients with cognitive dysfunction than in the patients with normal cognition （P 〈 0.05）. The IGF-1 level was positively correlated with the MoCA score at 1, 3 and 5 d after TBI in study group （P 〈 0.05）. Conclusion The dynamic change of serum IGF-1 level in patients with acute TBI is closely related to cognitive function. The serum IGF-1 level in the early stage after TBI can be used to predict the cognitive function of the patients.

关 键 词：颅脑损伤 急性 胰岛素样生长因子-1 认知功能障碍 

分 类 号：R651.15[医药卫生—外科学]