脑脊液可溶性血小板衍生生长因子受体β浓度与动脉瘤性蛛网膜下腔出血病人认知功能损害的关系  

Relationship between soluble platelet-derived growth factor receptor β level in cerebrospinal fluid and cognitive impairment in patients with aneurysmal subarachnoid hemorrhage

作　　者：刘胜[1] 廖建明 田其[1] 秦显尧 王建丰 何沛邦 李明昌[1] LIU Sheng;LIAO Jianming;TIAN Qi;QIN Xianyao;WANG Jianfeng;HE Peibang;LI Mingchang(Department Neurosurgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院神经外科,430060

出　　处：《临床外科杂志》2023年第7期630-633,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金面上项目(81971870,82172173)。

摘　　要：目的探讨脑脊液可溶性血小板衍生生长因子受体β(sPDGFRβ)浓度与动脉瘤性蛛网膜下腔出血(aSAH)病人认知功能损害的关系。方法前瞻性收集55例aSAH病人发病72小时内的脑脊液标本和20例因其他神经疾病需行脑脊液检查的对照组脑脊液标本,采用ELISA检测脑脊液中sPDGFRβ的浓度。出院6个月后对aSAH病人进行随访,使用简易智能精神状态检查量表(MMSE)或修订版认知功能电话问卷(TICS-m)评估认知功能。结果aSAH组脑脊液中sPDGFRβ浓度为(1.076±0.353)ng/ml,对照组为(0.574±0.057)ng/ml,两组比较,差异有统计学意义(P<0.05);55例aSAH病人中,19例发生了认知功能损害,有认知障碍的病人早期脑脊液中的sPDGFRβ浓度[(1.387±0.280)ng/ml]高于无认知障碍者[(0.911±0.268)ng/ml],两组比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示,Hunt-Hess分级Ⅳ~Ⅴ级、sPDGFRβ≥1.347 ng/ml是aSAH病人出院6个月后发生认知障碍的独立危险因素(P<0.01)。结论aSAH发生后,脑脊液sPDGFRβ浓度升高,且与病人发生认知功能损害有关。Objective To investigate the relationship between the level of soluble platelet-derived growth factor receptor β(sPDGFRβ)in cerebrospinal fluid and cognitive impairment in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods Cerebrospinal fluid samples from 55 aSAH patients within 72 hours and 20 controls were collected prospectively,and the concentration of sPDGFRβ in cerebrospinal fluid was detected by ELISA.Six months after discharge,aSAH patients were followed up by outpatient visit or telephone,and the cognitive function was evaluated by the Mini-Mental State Examination or the Telephone Interview for Cognitive Status-Modified.Results The concentration of sPDGFRβin cerebrospinal fluid was(1.076±0.353)ng/ml in aSAH group and(0.574±0.057)ng/ml in control group,and there was a statistically significant difference between the two groups(P<0.05).Among 55 aSAH patients,19 suffered from cognitive impairment.The concentration of sPDGFRβ in cerebrospinal fluid of patients with cognitive impairment[(1.387±0.280)ng/ml]was significantly higher than that of patients without cognitive impairment[(0.911±0.268)ng/ml](P<0.05).Multivariate regression analysis showed that Hunt-Hess grade Ⅳ~Ⅴ and sPDGFRβ≥1.347ng/ml were independent risk factors for cognitive impairment in aSAH patients 6 months after discharge(P<0.01).Conclusion The level of sPDGFRβ in cerebrospinal fluid increases after aSAH,associated with cognitive impairment in patients.

关 键 词：动脉瘤性蛛网膜下腔出血 可溶性血小板衍生生长因子受体β 认知功能 生物标志物 

分 类 号：R743.35[医药卫生—神经病学与精神病学]