血清脑源性神经生长因子、神经元PAS结构域蛋白4和神经元特异性烯醇化酶水平与急性缺血性脑卒中患者认知障碍的关系  

Relationship between the levels of brain-derived nerve growth factor,neuronal Per-Arnt-Sim domain protein 4,neuron-specific enolase and cognitive disorder in serum of patients with acute ischemic stroke

作　　者：孟涛[1] 李成刚 杨柳[1] 王洪军 MENG Tao;LI Chenggang;YANG Liu;WANG Hongjun(Department of Neurology,Chongqing Emergency Medical Center/Chongqing University Central Hospital,Chongqing 400014,China;Department of Neurology,Fengdu People′s Hospital of Chongqing,Chongqing 408200,China)

机构地区：[1]重庆市急救医疗中心/重庆大学附属中心医院神经内科,重庆400014 [2]重庆市丰都县人民医院神经内科,重庆408200

出　　处：《新乡医学院学报》2022年第8期777-780,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨血清脑源性神经生长因子(BDNF)、神经元PAS结构域蛋白4(NPAS4)、神经元特异性烯醇化酶(NSE)水平与急性缺血性脑卒中(AIS)患者认知障碍的关系。方法选择2018年6月至2020年6月重庆市丰都县人民医院收治的AIS患者128例为研究对象。根据患者入院治疗7~10 d时的简易精神状态量表(MMSE)评分结果将患者分为认知正常组(n=60,MMSE评分≥27分)和认知障碍组(n=68,MMSE评分<27分)。入院后1周,抽取2组患者晨起空腹外周静脉血5 mL,采用酶联免疫吸附试验检测血清中BDNF、NPAS4、NSE水平。采用Pearson相关分析BDNF、NPAS4、NSE水平与MMSE评分的关系,采用单因素分析和多因素logistic回归分析AIS患者发生认知障碍的危险因素。结果认知障碍组与认知正常组患者的年龄、性别、起病至入院时间、脑梗死部位及合并高血压、冠状动脉性心脏病、房颤的比例比较差异均无统计学意义(P>0.05);认知障碍组患者的美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、受教育年限、梗死病灶大小、合并糖尿病情况及血清BDNF、NPAS4、NSE水平与认知正常组比较差异有统计学意义(P<0.05)。AIS患者血清NPAS4、NSE水平与MMSE评分呈正相关(r=0.442、0.486,P<0.05),血清BDNF水平与MMSE评分呈负相关(r=-0.395,P<0.05)。血清NPAS4、NSE水平及NIHSS、GCS评分和梗死病灶大小是AIS患者发生认知障碍的独立危险因素(P<0.05);血清BDNF水平和受教育年限是AIS患者发生认知障碍的保护因素(P<0.05)。结论AIS患者发生认知障碍受到多种因素的影响。血清NPAS4、NSE水平升高是AIS患者发生认知障碍的独立危险因素,血清中BDNF水平升高是AIS患者发生认知障碍的保护因素。Objective To explore the relationship between the levels of brain-derived nerve growth factor(BDNF),neuronal Per-Arnt-Sim domain protein 4(NPAS4),neuron-specific enolase(NSE)and cognitive disorder in serum of patients with acute ischemic stroke(AIS).Methods A total of 128 AIS patients admitted to the Fengdu People′s Hospital of Chongqing from June 2018 to June 2020 were selected as the research objects.According to the mini-mental state examination(MMSE)scores at 7-10 d of admission,the patients were divided into normal cognitive group(n=60,MMSE score≥27)and cognitive disorder group(n=68,MMSE score<27).One week after admission,5 mL of fasting peripheral venous blood was taken from the patients in the two groups,and the levels of BDNF,NPAS4 and NSE in serum of patients were detected by enzyme-linked immunosorbent assay.The relationships between the serum BDNF,NPAS4,NSE levels and MMSE score were analyzed by Pearson correlation.The risk factors of cognitive disorder in AIS patients was analyzed by univariate analysis and multivariate logistic regression.Results There was no significant difference in age,gender,time from onset to admission,site of cerebral infarction and the proportion of patients with hypertension,coronary heart disease,atrial fibrillation between the cognitive disorder group and the normal cognitive group(P>0.05);there were significant difference in National Institute of Health stroke scale(NIHSS)score,Glasgow coma scale(GCS)score,years of education,size of infarction lesions,combined with diabetes and serum BDNF,NPAS4,NSE levels between the cognitive disorder group and the normal cognitive group(P<0.05).The serum NPAS4,NSE levels of patients with AIS were positively correlated with MMSE scores(r=0.442,0.486;P<0.05);the serum BDNF level of patients was negatively correlated with MMSE scores(r=-0.395,P<0.05).The serum NPAS4 and NSE levels,NIHSS and GCS scores and the size of infarct lesions were independent risk factors for cognitive disorder in patients with AIS(P<0.05).The serum BDNF level an

关 键 词：急性缺血性脑卒中 脑源性神经生长因子 神经元PAS结构域蛋白4 神经元特异性烯醇化酶 认知障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]