老年缺血性脑卒中患者VEGF及IMD水平及与卒中后认知功能的关系  

Expressions of VEGF and IMD in Elderly Patients with Ischemic Stroke and Their Relationships with Cognitive Function After Stroke

作　　者：张依[1] 朱娅丽[1] 严之红[1] 纪红[1] ZHANG Yi;ZHU Yali;YAN Zhihong;JI Hong(Department of Gereology, Aerospace Center Hospital, Beijing 100049, China)

机构地区：[1]航天中心医院老年医学二科,北京100049

出　　处：《标记免疫分析与临床》2020年第11期1873-1876,1885,共5页Labeled Immunoassays and Clinical Medicine

基　　金：2019年中国航天科工集团课题项目(老年轻度认知障碍(MCI)筛查及认知康复研究)(编号:2019-LCYL-012)。

摘　　要：目的探讨老年缺血性脑卒中患者血管内皮生长因子(vascular endothelial growth factor,VEGF)及中介素(intermedin,IMD)的水平,及其与卒中后认知功能的关系。方法入组老年缺血性脑卒中患者116例,采用简明精神状态量表(mini-mental state examination scale,MMSE)评估患者卒中后认知功能,记录入组患者的基本临床资料,采用ELISA法检测患者血清VEGF和IMD水平;采用Pearson相关分析分析血清VEGF和IMD的相关性,及其与MMSE评分相关性。采用多因素Logistic回归分析老年缺血性脑卒中患者发生认知障碍的影响因素。结果(1)与无认知功能障碍组相比,认知功能障碍组的吸烟率、饮酒率、血压、FPG、HbA1c、Hcy、CRP、MMSE、VEGF、IMD的差异有统计学意义(P<0.05);(2)在认知障碍组间,Hcy、CRP、MMSE、VEGF、IMD差异均具有统计学意义(P<0.05);(3)血清VEGF及IMD水平与MMSE评分(r=0.838 P<0.001;r=0.717 P<0.001)呈正相关,血清VEGF与IMD水平呈正相关(r=0.893 P<0.001);(4)高血压(OR=2.29,95%CI:1.57~4.87,P=0.036),Hcy(OR=2.68,95%CI:1.18~7.45,P=0.022),CRP(OR=7.63,95%CI:3.28~14.64,P<0.001),VEFG(OR=2.43,95%CI:1.26~6.34,P=0.013)及IMD水平(OR=1.59,95%CI:1.17~4.49,P<0.001)是老年脑卒中患者是否合并认知障碍的独立影响因素,其中VEGF和IMD是老年患者脑卒中后认知功能的保护性因素。结论VEGF及IMD在老年缺血性脑卒中后认知障碍的发生发展中发挥着重要作用。Objective This study investigated the expression levels of vascular endothelial growth factor(VEGF)and intermedin(IMD)in elderly patients with ischemic stroke and their relationships with cognitive function.Methods A total of 116 cases of elderly patients with ischemic stroke were tested by Mini-Mental State Examination Scale(MMSE).Then the basic clinical data of each group was collected.The levels of VEGF and IMD were tested by ELISA method.Pearson correlation analysis was used to analyze the correlation between serum VEGF and IMD expression levels and MMSE score.Furthermore,multivariate logistic regression was used to analyze the influencing factors of cognitive function in patients.Results(1)Compared with the non-cognitive dysfunction group,the smoking rate,drinking rate,blood pressure,FPG,HbA1c,Hcy,CRP,MMSE,VEGF and IMD levels in the cognitive dysfunction group showed significant differences(P<0.05);(2)There were significant differences in Hcy,CRP,MMSE,VEGF,and IMD among different cognitive dysfunction groups(P<0.05);(3)Serum VEGF and IMD expression levels were positively correlated with MMSE score(r=0.838 P<0.001;r=0.717 P<0.001),and VEGF level was positively correlated with IMD expression level(r=0.893 P<0.001);(4)Hypertension(OR=2.29,95%CI:1.57-4.87,P=0.036),Hcy(OR=2.68,95%CI:1.18-7.45,P=0.022),CRP(OR=7.63,95%CI:3.28-14.64,P<0.001),VEGF(OR=2.43,95%CI:1.26-6.34,P=0.013)and IMD(OR=1.59,95%CI:1.17-4.49,P<0.001)were independent factors,while VEGF and IMD were protective factors of cognitive function in elderly patients after stroke.Conclusion VEGF and IMD can play an important role in the occurrence and development of ischemic stroke patients with cognitive dysfunction.

关 键 词：缺血性脑卒中 认知功能障碍 血管内皮生长因子 中介素 

分 类 号：R743[医药卫生—神经病学与精神病学]