血清闭锁蛋白和闭锁小带蛋白1表达与老年急性脑梗死患者认知功能障碍的相关性  

The correlation between the expression of occludin and zonula occludens-1 in serum and the cognitive impairment in elderly patients with acute cerebral infarction

作　　者：王景 董坤 陈海云 杨青兰 WANG Jing;DONG Kun;CHEN Hai-Yun(Department of Neurology,Sanya Central Hospital,Sanya 572000,Hainan,China)

机构地区：[1]三亚中心医院神经内科,海南三亚572000

出　　处：《中国老年学杂志》2023年第1期21-24,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81603217)。

摘　　要：目的探讨血清闭锁蛋白(occludin)、闭锁小带蛋白(ZO)-1表达与老年急性脑梗死患者认知功能障碍的相关性。方法老年急性脑梗死患者70例(观察组),另选取同期健康体检者70例(对照组),采用酶联免疫吸附试验检测两组血清occludin、ZO-1水平,采用美国国立卫生研究院脑卒中量表(NIHSS)和蒙特利尔认知评价(MoCA)量表评分对老年急性脑梗死患者认知功能障碍进行评估,Pearson分析老年急性脑梗死患者血清occludin、ZO-1水平与认知功能障碍的相关性,受试者工作特征(ROC)曲线分析血清occludin、ZO-1水平对老年急性脑梗死的诊断价值,Logistic回归分析影响老年急性脑梗死患者认知功能障碍的因素。结果观察组平均动脉压、平均心率及NIHSS评分明显高于对照组,血清occludin、ZO-1水平及MoCA评分明显低于对照组(P<0.05);老年急性脑梗死患者血清occludin、ZO-1水平与NIHSS评分呈负相关,与MoCA评分呈正相关(P<0.05)。ROC曲线分析显示,血清occludin诊断老年急性脑梗死的曲线下面积为0.885,截断值为41.152 ng/ml,敏感性为92.9%,特异性为77.1%。血清ZO-1诊断老年急性脑梗死的曲线下面积为0.666,截断值为33.670 ng/ml,敏感性为81.4%,特异性为55.7%。血清occludin、ZO-1联合诊断老年急性脑梗死的曲线下面积为0.928,敏感性为90.0%,特异性为84.3%。经校正混杂因素后,Logistic回归分析结果显示,血清occludin和ZO-1低表达均为影响老年急性脑梗死患者认知功能障碍的独立危险因素。结论血清occludin、ZO-1水平明显降低对老年急性脑梗死具有一定的诊断价值,并与认知功能障碍有关,可能作为急性脑梗死辅助诊断指标。Objective To investigate the correlation between the expression of serum occludin and zonula occludens(ZO)-1 and cognitive impairment in elderly patients with acute cerebral infarction.Methods There were 70 elderly patients with acute cerebral infarction(observation group)and 70 healthy people(control group)who underwent physical examination during the same period.The levels of serum occludin and ZO-1 were detected by enzyme-linked immunosorbent assay,the national institutes of health stroke scale(NIHSS)and montreal cognitive assessment(MoCA)scale were used to assess the cognitive impairment of elderly patients with acute cerebral infarction.Pearson method was used to analyze the correlation between the levels of serum occludin,ZO-1 and cognitive impairment in elderly patients with acute cerebral infarction;and receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum occludin and ZO-1 levels in elderly patients with acute cerebral infarction.Logistic regression analysis was used to analyze the influencing factors of cognitive dysfunction in elderly patients with acute cerebral infarction.Results The mean arterial pressure,average heart rate and NIHSS score in the observation group were significantly higher than those in control group,and the levels of occludin and ZO-1 in serum and MoCA score were significantly lower than those in control group(P<0.05).The levels of elderly patients with acute cerebral infarction serum occludin and ZO-1 were negatively correlated with NIHSS score,and positively correlated with MoCA score(P<0.05).ROC curve analysis showed that the area under the curve of serum occludin in the diagnosis of senile acute cerebral infarction was 0.885,the cutoff value was 41.152 ng/ml,the sensitivity was 92.9%,and the specificity was 77.1%.The area under the curve of serum ZO-1 was 0.666,the cutoff value was 33.670 ng/ml,the sensitivity was 81.4%,and the specificity was 55.7%;the area under the curve of serum occludin combined with ZO-1 in the diagnosis of senile a

关 键 词：急性脑梗死 闭锁蛋白 闭锁小带蛋白1 认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]