急性脑梗死患者血清BDNF、IL-6和TNF-α含量与血管性认知障碍关系的临床分析  

Clinical analysis of the relationship between serum BDNF, IL-6, TNF-α levels and vascular cognitive impairment after acute cerebral infarction

作　　者：欧春影[1] 李传玲[1] 安晓雷[1] 李晓宾[1] 郭靖[1] 许可[1] Ou Chunying;Li Chuanling;An Xiaolei;Li Xiaobin;Guo Jing;Xu Ke(Department of Neurology,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院神经内科

出　　处：《中华脑科疾病与康复杂志（电子版）》2019年第3期163-167,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：江苏省科技厅临床医学专项课题(BL2014028)

摘　　要：目的探讨急性脑梗死血清脑源性神经营养因子(BDNF)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)含量与血管性认知障碍(VCI)关系的临床分析,为早期预防VCI提供一定的理论依据。方法收集徐州市中心医院神经内科自2016年7月至2017年1月收治的急性脑梗死患者142例为研究组,选择同期无器质性病变的成人血清40例作为对照组,在脑梗死后急性期(0~7 d)、恢复期(16~30 d)及脑梗死后3个月进行血清BDNF、IL-6、TNF-α的测定,随访3个月,根据简易精神状态检查表和中文版蒙特利认知评分量表,将142例急性脑梗死患者根据预后分为2组,非认知障碍组和认知障碍组;比较2组BDNF、IL-6、TNF-α的差异,评估血清BDNF、IL-6、TNF-α含量与VCI关系。结果研究组在急性期、恢复期的BDNF、IL-6、TNF-α均高于对照组,差异均具有统计学意义(P<0.05);研究组在脑梗死后3个月的BDNF、TNF-α高于对照组,差异无统计学意义(P>0.05);研究组在脑梗死后3个月的IL-6高于对照组,差异具有统计学意义(P<0.05)。观察3个月,142例急性脑梗死患者,29例发生VCI,为认知障碍组;113例没有VCI,为非认知障碍组。非认知障碍组在急性期、恢复期、脑梗死后3个月的BDNF高于认知障碍组,特别是恢复期,BDNF含量明显增高,差异具有统计学意义(t=2.405,P=0.017)。非认知障碍组在急性期、恢复期、脑梗死后3个月的IL-6、TNF-α均低于认知障碍组,差异均具有统计学意义(P<0.05)。结论BDNF、IL-6、TNF-α参与脑梗死后VCI的病理过程,BDNF在脑梗死后VCI有保护作用;IL-6、TNF-α在脑梗死后VCI可能存在负作用。Objective To investigate the relationship between serum levels of brain-derived neurotrophic factor(BDNF),interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and vascular cognitive impairment(VCI)in patients with acute cerebral infarction,and to provide some theoretical basis for early prevention of VCI.Methods One hundred and forty-two patients with acute infarction who were hospitalized in Department of Neurology of Xuzhou Central Hoapital from July 2016 to January 2017 were included in the research group,and 40 adults with no organic lesions were included in the control group.Serum levels of BDNF,IL-6,TNF-αwere measured in acute phase(0-7 d),recovery period(16-30 d)and 3 months after cerebral infarction.Followed-up for 3 months,according to the mini-mental state examination and the Chinese version of the Monterey cognitive rating scale,142 patients with acute cerebral infarction were divided into two groups:non-cognitive impairment group and cognitive impairment group;the difference of BDNF,IL-6 and TNF-αwas compared between the two groups to evaluate the relationship between the content of BDNF,IL-6 and TNF-αwith VCI.Results Compared with the control group,the levels of serum BDNF,IL-6 and TNF-αin the acute phase,recovery period and 3 months after acute cerebral infarction were higher than those in the control group;the difference was statistically significant(P<0.05).The BDNF and TNF-αlevel in the phase of 3 months after acute cerebral infarction was higher than that in the control group,but the difference was not statistically significant(P>0.05).IL-6 of 3 months after acute cerebral infarction was higher than that in the control group and the difference was statistically significant(P<0.05).After 3 months of observation,of the 142 patients with acute cerebral infarction,VCI occurred in 29 patients,113 other patients had no VCI.BDNF of the non-cognitive impairment group in the acute phase,recovery phase,and 3 months of acute cerebral infarction were higher than that in the cognitive impairment group,esp

关 键 词：脑梗死 血管性认知障碍 急性期 脑源性神经营养因子 白细胞介素-6 肿瘤坏死因子Α 

分 类 号：R74[医药卫生—神经病学与精神病学]