腔隙性脑梗死患者血清Lp-PLA2及MIF水平与认知功能障碍的相关性研究  

Correlation between the Levels of Lp-PLA2 and MIF in Serum and Cognitive Dysfunction in Patients with Lacunar Infarction

作　　者：杨瑜 薛伟 孔维 YANG Yu;XUE Wei;KONG Wei(Department of Clinical Laboratory,the First People’s Hospital of Xianyang City,Shaanxi Xianyang 712000,China;Department of Blood Transfusion,the First People’s Hospital of Xianyang City,Shaanxi Xianyang 712000,China;Department of Neurology,the First People’s Hospital of Xianyang City,Shaanxi Xianyang 712000,China)

机构地区：[1]咸阳市第一人民医院检验科,陕西咸阳712000 [2]咸阳市第一人民医院输血科,陕西咸阳712000 [3]咸阳市第一人民医院神经内科,陕西咸阳712000

出　　处：《现代检验医学杂志》2021年第3期132-136,共5页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)及巨噬细胞游走抑制因子(macrophage migration inhibitory factor,MIF)水平与腔隙性脑梗死(lacunar infarction,LI)患者认知功能障碍的相关性。方法收集2018年3月~2020年3月期间在咸阳市第一人民医院就诊的90例LI患者的临床资料进行回顾性分析,依据患者是否有认知功能障碍将其分为认知功能正常组(正常组47例)和认知功能障碍组(障碍组43例)。另选取45例同期体检健康者作为对照组。采用酶联免疫吸附法检测血清Lp-PLA2及MIF水平。所有研究对象均接受蒙特利尔认知功能评估(Montreal Cognitive Assessment,MoCA)以及颈动脉超声检查,通过彩色多普勒超声诊断仪获得所有研究对象的颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)。比较分析以上指标的变化与LI患者认知功能障碍的相关性。结果对照组、正常组和障碍组的血清Lp-PLA2和MIF水平分别为(8.63±2.79,17.26±3.93,25.67±5.03μg/L和60.17±11.29,83.35±15.30,105.28±20.19ng/ml)。与对照组比较,正常组和障碍组的Lp-PLA2和MIF水平明显增高,且障碍组增高更显著(F=16.068~33.693,均P=0.000)。相关性分析显示,正常组和障碍组的血清Lp-PLA2和MIF水平分别呈正相关性(r=0.826,0.850,均P<0.01)。正常组的MIF及Lp-PLA2分别与MoCA评分及CIMT呈正相关性(r_(MIF)=0.809,0.816,均P<0.01;r_(Lp-PLA2)=0.789,0.802,均P<0.01),障碍组的MIF及Lp-PLA2水平分别与MoCA评分及CIMT呈正相关性(r_(MIF)=0.830,0.842,P均<0.01;r_(Lp-PLA2)=0.828,0.835,均P<0.01)。结论Lp-PLA2及MIF与LI患者认知功能障碍的发生相关。检测血清Lp-PLA2及MIF水平可评估LI的进展并预测LI的预后,其差异性的变化可以反映LI患者认知功能障碍发展过程。Objective To investigate the relationship between the levels of lipoprotein associated phospholipase A2(Lp-PLA2),macrophage migration inhibitory factor(MIF)in serumand cognitive dysfunction in patients with lacunar infarction(LI).Methods The clinical data of 90 patients with LI treated in the First People’s Hospital of Xianyang City from March 2018 to March 2020 were retrospectively analyzed.According to whether the patients had cognitive impairment,they were divided into normal cognitive function group(normal group 47 cases)and cognitive impairment group(impairment group 43 cases).Serum Lp-PLA2 and MIF levels were measured by enzyme-linked immunosorbent assay.All subjects underwent Montreal Cognitive Assessment(MoCA)and carotid ultrasound examination.The carotid intima-media thickness(CIMT)of all subjects was obtained by color Doppler ultrasound.The correlation between the changes of the above indexes and cognitive dysfunction in patients with LI was analyzed.Results The levels of Lp-PLA2 and MIF were 8.63±2.79,17.26±3.93,25.67±5.03μg/L and 60.17±11.29,83.35±15.30,105.28±20.19ng/ml in the control group,the normal group and the disorder group,respectively.The levels of Lp-PLA2 and MIF in the normal group and the obstacle group were significantly higher than those in the control group(F=16.068~33.693,all P=0.000),The levels of MIF and Lp-PLA2 were positively correlated with MOCA score and CIMT in normal group(r_(MIF)=0.809,0.816,P<0.01;r_(Lp-PLA2)=0.789,0.802,P<0.01),respectively.The levels of MIF and Lp-PLA2 were positively correlated with MOCA score and CIMT(r_(MIF)=0.830,0.842,P<0.01;r_(Lp-PLA2)=0.828,0.835,P<0.01).Conclusion Lp-PLA2 and MIF were associated with cognitive dysfunction in patients with LI.Detection of serum Lp-PLA2 and MIF levels can evaluate the progress of LI and predict the prognosis of LI.The difference of the changes can reflect the development of cognitive dysfunction in LI patients.

关 键 词：腔隙性脑梗死 认知功能障碍 脂蛋白相关磷脂酶A2 巨噬细胞游走抑制因子 蒙特利尔认知功能评估 颈动脉内膜中层厚度 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]