皮质下缺血性脑血管病患者血压变异性及血清ROS、SOD水平对认知功能的影响  

Effects of blood pressure variability and serum reactive oxygen species and superoxide dismutase levels on cognitive function in patients with subcortical ischemic vascular disease

作　　者：常璐 尹昌浩 杜晓 罗锐迪 王建行 赵维纳 Chang Lu;Yin Changhao;Du Xiao;Luo Ruidi;Wang Jianhang;Zhao Weina(Department of Neurology,Red Flag Hospital Affiliated to Mudanjiang Medical University,Heilongjiang Provincial Key Laboratory of Ischemic Stroke Prevention and Treatment,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院附属红旗医院神经内科,黑龙江省缺血性脑卒中防治重点实验室,牡丹江157011

出　　处：《中华神经医学杂志》2023年第5期462-469,共8页Chinese Journal of Neuromedicine

基　　金：黑龙江省卫生健康委科研课题(20220303070632);牡丹江市应用技术研究与开发计划项目(SQ2022NS076)。

摘　　要：目的探讨血压变异性(BPV)及血清活性氧(ROS)、超氧化物歧化酶(SOD)水平变化对皮质下缺血性脑血管病(SIVD)患者认知功能的影响。方法选择牡丹江医学院附属红旗医院神经内科自2021年10月至2022年10月收治的133例经颅脑MRI检查证实的SIVD患者为研究对象,依据蒙特利尔认知评估量表评分将其分为无认知障碍SIVD组(SIVD-NC组,39例)与皮质下血管性认知障碍组(SVCI组,94例),并纳入同期于体检中心经颅脑MRI平扫未见异常且认知正常的健康志愿者23例为对照组。收集各组受试者的一般资料及血管危险因素,检测外周血生化常规指标,进行24 h动态血压监测以及应用酶联免疫吸附法检测血清ROS、SOD水平,并采用统计学方法分析SIVD患者认知障碍的危险因素以及各独立危险因素与认知功能的相关性、对SIVD患者认知障碍的诊断价值。结果(1)与对照组比较,SIVD-NC组患者中高血压病史、腔隙性脑卒中史比例明显增高,超敏C反应蛋白水平明显升高;与对照组及SIVD-NC组比较,SVCI组患者的年龄明显较高,受教育年限明显较低,腔隙性脑卒中史比例明显更高,超敏C反应蛋白水平明显升高;与对照组比较,SVCI组患者中高血压病史比例明显增高,差异均有统计学意义(P<0.05)。(2)与对照组比较,SIVD-NC组患者血清ROS水平明显升高;与对照组及SIVD-NC组比较,SVCI组患者血清ROS水平明显升高,差异均有统计学意义(P<0.05)。(3)与对照组比较,SIVD-NC组患者的夜间收缩压(nSBP)明显升高;与对照组及SIVD-NC组比较,SVCI组患者的24 h SBP、nSBP、nSBP变异系数明显升高;与SIVD-NC组比较,SVCI组患者的24 h SBP变异系数明显升高,差异均有统计学意义(P<0.05)。(4)nSBP、nSBP变异系数及血清超敏C反应蛋白、ROS、腔隙性脑卒中史是SIVD认知障碍的独立危险因素(OR=1.096,P<0.001,95%CI:1.042~1.154;OR=1.231,P=0.010,95%CI:1.050~1.443;OR=2.303,P=0.004,95%CI:1.311~4.039;OR=1.026,P<Objective To investigate the effects of blood pressure variability(BPV),serum reactive oxygen species(ROS)and superoxide dismutase(SOD)levels on cognitive function in patients with subcortical ischemic vascular disease(SIVD).Methods A total of 133 patients with SIVD confirmed by craniocranial MRI admitted to Department of Neurology,Red Flag Hospital Affiliated to Mudanjiang Medical University from October 2021 to October 2022 were selected.According to Montreal Cognitive Assessment scores,they were divided into SIVD without cognitive impairment group(SIVD-NC group,n=39)and subcortical vascular cognitive impairment group(SVCI group,n=94);and 23 healthy volunteers with normal cognition who had normal brain MRI in the Physical Examination Center during the same period were chosen as control group.General data of all subjects and vascular risk factors in each group were collected,routine biochemical indexes of peripheral blood were detected,24 h ambulatory blood pressure monitoring was performed,and serum ROS and SOD levels were detected by enzyme-linked immunosorbent assay.Statistical methods were used to analyze the risk factors for cognitive impairment,correlations of independent risk factors with cognitive function,and diagnostic value of risk factors in cognitive impairment in patients with SIVD.Results(1)Compared with control group,SIVD-NC group had significantly increased percentages of patients with hypertension history or lacunar stroke history,and significantly increased hypersensitive C-reactive protein(hs-CRP)level(P<0.05).Compared with control group and SIVD-NC group,patients in SVCI group had significantly older age,lower years of education,higher proportion of patients with lacunar stroke history,and increased hs-CRP level(P<0.05).Compared with control group,SVCI group had significantly higher proportion of patients with hypertension history(P<0.05).(2)SIVD-NC group had significantly higher ROS level than control group(P<0.05);Compared with control group and SIVD-NC group,SVCI group had significantly i

关 键 词：皮质下缺血性脑血管病 皮质下血管性认知障碍 血压变异性 活性氧 超氧化物歧化酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]