脑白质高信号患者血清CX3CL1水平与认知功能障碍的关系  

The relationship between serum CX3CL1 level and cognitive dysfunction in patients with white matter hyperintensity

作　　者：李琼 赵建华[1] 刘昊 王凡 李青[1] 陈希妍[1] 蔡瑞艳[1] 吴清武[2] 张健[2] 吉四辈[1] 路承彪[3] 李少敏 Li Qiong;Zhao Jianhua;Liu Hao;Wang Fan;Li Qing;Chen Xiyan;Cai Ruiyan;Wu Qingwu;Zhang Jian;Ji Sibei;Lu Chengbiao;Li Shaomin(Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia,Henan Key Laboratory of Neurorestoratology Department of Neurology,First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China;Imaging Department,First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China;Sino-UK Joint Laboratory of Brain Function and Injury of Henan Province,Department of Physiology and Neurobiology,Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Ann Romney Center for Neurologic Diseases,Brigham and Women’s Hospital,Harvard Medical School,Boston 02115,USA)

机构地区：[1]新乡医学院第一附属医院神经内科、河南省神经修复重点实验室、河南省老年性痴呆神经修复国际联合实验室,河南新乡453000 [2]新乡医学院第一附属医院影像科,河南新乡453000 [3]新乡医学院生理学与神经生物学教研室,河南省无创性神经调制国际联合实验室,河南新乡453000 [4]美国哈佛大学医学院布莱根妇女医院神经疾病研究中心,美国波士顿02115

出　　处：《首都医科大学学报》2023年第1期6-12,共7页Journal of Capital Medical University

基　　金：国家自然科学基金(81771517);河南省自然科学基金项目(182300410389);河南省医学科技攻关计划联合共建项目(LHGJ20190437)。

摘　　要：目的探究脑白质高信号(white matter hyperintensity,WMH)患者血清趋化因子C-X3-C配体1(chemokine C-X3-C-motif ligand 1,CX3CL1),也被称作分形趋化因子(fractalkine,Fkn)的水平与认知功能障碍的相关性。方法纳入2020年3月至2022年8月于新乡医学院第一附属医院神经内科影像学表现有WMH的脑小血管病(cerebral small vessel disease,CSVD)住院患者,收集患者一般临床资料、头颅核磁常规序列、生化指标,测定CX3CL1水平及评估简易认知量表(Mini-mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA),分析血清CX3CL1水平与WMH及认知功能的相关性。结果共纳入152例受试者,根据MMSE结果分为认知功能正常组(77例)及认知功能障碍组(75例),平均年龄分别为(59.60±8.84)岁和(62.91±7.99)岁。相关性分析结果显示CX3CL1水平与视空间与执行功能、注意力、定向力分别呈负相关性(r=-0.227,P=0.008、r=-0.186,P=0.030、r=-0.172,P=0.046)。回归分析结果显示CX3CL1水平、白质高信号严重程度及深部白质病变是认知功能障碍的危险因素。受试者工作特征(receiver operating characteristic,ROC)曲线分析提示CX3CL1水平对认知障碍可能具有潜在的预测价值。结论血清CX3CL1水平、WMH与认知功能具有相关性,且血清CX3CL1水平升高是认知功能障碍发生的危险因素。Objective To explore the correlation between serum chemokine C-X3-C-motif ligand 1(CX3CL1),also know as fractalkine(Fkn).levels and cognitive dysfunction in patients with white matter hyperintensity(WMH).Methods A total of 152 patients with cerebral small vessel disease(CSVD)enrolled in the First Affiliated Hospital of Xinxiang Medical University from March 2020 to August 2022 were collected.The general clinical data of patients,the routine sequence of cranial magnetic resonance imaging(MRI),biochemical indicators,serum CX3CL1 level,and Mini-mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)cognitive scores were collected,and the correlation between serum CX3CL1 levels and white matter hyperintensity and cognitive function was analyzed.Results A total of 152 participants were enrolled and divided into the group with normal cognitive function and the group of cognitive dysfunction according to the MMSE results,with the mean age of(59.60±8.84)years and(62.91±7.99)years,respectively.The correlation analysis results showed that CX3CL1 level and apparent space were negatively correlated with executive function,attention,and orientation.Regression analysis showed that CX3CL1 levels and white matter high-signal were risk factors for cognitive dysfunction.Receiver operating characteristic(ROC)curve analysis suggested that CX3CL1 levels may have potential predictive value for cognitive impairment.Conclusion Serum CX3CL1 levels and white matter hyperintensity are associated with cognitive function,and elevated serum CX3CL1 levels are risk factors for the development of cognitive dysfunction.

关 键 词：趋化因子C-X3-C配体1 脑白质高信号 认知功能 脑小血管病 

分 类 号：R742[医药卫生—神经病学与精神病学]