血清pTau181、Lp-PLA2水平与急性脑梗死并发血管性痴呆的关系  

Relationships between serum pTau181,Lp-PLA2 levels and vascular dementia in patients with acute cerebral infarction

作　　者：徐康 刘启为[1] 陆艳卉 郭佳 韩素桂[1] 刘泽民[2] XU Kang;LIU Qiwei;LU Yanhui;GUO Jia;HAN Sugui;LIU Zemin(Department of Nuclear Medicine Laboratory,Tangshan People's Hospital,Tangshan 063001,China;不详)

机构地区：[1]唐山市人民医院核医学检验科,河北唐山063001 [2]唐山市人民医院神经内科

出　　处：《山东医药》2023年第1期32-36,共5页Shandong Medical Journal

基　　金：河北省医学科学研究课题计划(20190172)。

摘　　要：目的探讨血清磷酸化Tau181(pTau181)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与急性脑梗死(ACI)并发血管性痴呆(VD)的关系。方法选择ACI患者163例,根据是否并发VD分为VD组60例和非VD组103例,其中VD组认知功能损伤程度轻度15例、中度32例、重度13例。所有研究对象入组次日采集清晨空腹肘静脉血,离心留取上层血清,采用ELISA法检测血清pTau181,采用上转发光法检测血清Lp-PLA2。采用多因素Logistic回归模型分析ACI并发VD的危险因素,采用受试者工作特征(ROC)曲线分析血清pTau181、Lp-PLA2水平对ACI并发VD的预测价值。结果VD组血清pTau181、Lp-PLA2水平均显著高于非VD组(P均<0.05);随着认知功能损伤程度加重,ACI并发VD患者血清pTau181、Lp-PLA2水平逐渐升高(P均<0.05)。多因素Logistic回归分析显示,2型糖尿病、pTau181、Lp-PLA2均为ACI并发VD的危险因素(P均<0.05)。ROC曲线分析显示,血清pTau181、Lp-PLA2水平联合预测ACI并发VD的曲线下面积显著高于血清pTau181、Lp-PLA2水平单独(P均<0.05)。结论血清pTau181、Lp-PLA2水平为ACI并发VD的独立危险因素,并可作为预测ACI并发VD的生物标志物。Objective To investigate the relationships between serum phosphorylated Tau-181(pTau181),lipoprotein-associated phospholipase A2(Lp-PLA2)and vascular dementia(VD)in patients with acute cerebral infarction(ACI).Methods Totally 163 patients with ACI were divided into the VD group(60 cases)and non-VD group(103 cases)according to whether VD occurred or not.In the VD group,15 patients had mild cognitive impairment,32 patients had moderate cognitive impairment,and 13 patients had severe cognitive impairment.On the next day of enrollment,we collected all subjects’fasting elbow vein blood in the morning,and centrifuged the upper serum.The serum pTau181 was detected by ELISA,and serum Lp-PLA2 was detected by up-forwarding light method.Multivariate Logistic regression model was used to analyze the risk factors of VD in patients with ACI,and the predictive value of serum pTau181 and Lp-PLA2 levels for patients with ACI complicated with VD was analyzed using the receiver operating characteristic(ROC)curve.Results The serum pTau181 and Lp-PLA2 levels in the VD group were significantly higher than those in the non-VD group(both P<0.05).With the aggravation of cognitive impairment,the serum pTau181 and Lp-PLA2 levels in patients with ACI complicated with VD gradually increased(both P<0.05).Multivariate Logistic regression analysis showed that type 2 diabetes mellitus,pTau181 and Lp-PLA2 were all risk factors of VD in ACI patients(all P<0.05).The ROC curve analysis showed that the area under the curve of serum pTau181 combined with Lp-PLA2 in predicting VD in patients with ACI was significantly higher than that of serum pTau181 and Lp-PLA2 levels alone(both P<0.05).Conclusion Serum pTau181 and Lp-PLA2levels are independent risk factors for VD in ACI patients,and can be used as biomarkers to predict VD in ACI patients.

关 键 词：急性脑梗死 血管性痴呆 磷酸化Tau181 脂蛋白相关磷脂酶A2 

分 类 号：R743.1[医药卫生—神经病学与精神病学]