脑白质病变严重程度与白细胞介素33、局部脑血流量的相关性  

Correlation of the severity of white matter lesion with IL-33 and regional cerebral blood flow

作　　者：韩玥莹 姚雪 刘瑶 于宁 魏依兰 窦志杰[1] 张晓璇[1] HAN Yueying;YAO Xue;LIU Yao(Department of Neurology,The Affiliated Hospital of Chengde Medical University,Chengde 067000,China)

机构地区：[1]承德医学院附属医院神经内科,河北承德067000

出　　处：《中风与神经疾病杂志》2023年第8期718-722,共5页Journal of Apoplexy and Nervous Diseases

基　　金：承德市应用技术研究与开发暨可持续发展议程创新示范区专项科技计划项目(202205B075)。

摘　　要：目的探讨缺血性脑白质病变(white matter ischemic lesions,WMIL)患者血清白细胞介素33(interleukin 33,IL-33)的水平及脑白质病区局部脑血流量(regional cerebral blood flow,rCBF)与WMIL严重程度的相关性。方法选取2021年11月-2022年4月我院收治的WMIL患者104例,依据Fazekas量表评估患者严重程度进行分组,分为轻度组36例,中度组42例,重度组26例。收集年龄、高血压、糖尿病等病史,收集总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、同型半胱氨酸、糖化血红蛋白、血清肌酐、尿素等资料;测定血清IL-33水平,采用动脉自旋标记技术(ASL)测半卵圆中心及侧脑室旁rCBF值进行比较,采用多因素Logistic回归分析血清IL-33、半卵圆中心及侧脑室旁rCBF值与WMIL严重的相关性。结果与轻度组比较中度、重度组年龄、高血压、肌酐、同型半胱氨酸明显升高(P<0.05),重度组IL-33、rCBF值较轻、中度组明显下降(P<0.01)。校正高血压、年龄等因素后,Logistic回归分析显示,IL-33水平、侧脑室旁及半卵圆中心rCBF值是缺血性脑白质病变严重程度增加的保护性因素(OR=0.818,95%CI 0.715~0.935,P=0.003;OR=0.659,95%CI 0.506~0.859,P=0.002;OR=0.817,95%CI 0.692~0.966,P=0.018)。Spearman等级相关分析显示,血清IL-33水平、侧脑室旁、半卵圆中心rCBF值与缺血性脑白质病变严重程度呈负相关(r=-0.575,P<0.01;r=-0.607,P<0.01;r=-0.644,P<0.01)。结论IL-33、侧脑室旁及半卵圆中心rCBF值可能与WMIL严重程度相关。Objective To investigate the correlation of serum interleukin 33(IL-33)level and regional cerebral blood flow(rCBF)in white matter lesions with the severity of white matter ischemic lesions(WMILs)in patients with WMILs.Methods A total of 104 patients with WMILs admitted to our hospital from November 2021 to April 2022 were divided into mild group(n=36),moderate group(n=42),and severe group(n=26)according to the Fazekas scale scores.Age,histories of hypertension and diabetes,and data of total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine,glycosylated hemoglobin,serum creatinine,and urea were collected.The serum IL-33 level was measured.The values of rCBF in the centrum semiovale and periventricular area were measured by arterial spin labeling.Multivariate Logistic regression was used to analyze the correlation of serum IL-33 level and rCBF values in the centrum semiovale and periventricular area with the severity of WMILs.Results The age,hypertension,creatinine,and homocysteine in the moderate and severe groups were significantly higher than those in the mild group(P<0.05),and the IL-33 level and rCBF values in the severe group were significantly lower than those in the mild and moderate groups(P<0.01).After adjusting for hypertension,age,and other factors,Logistic regression analysis showed that IL-33 level and rCBF values in the periventricular area and centrum semiovale were protective factors for the increased severity of WMILs[odds ratio(OR)=0.818,95%confidence interval(CI)0.715-0.935,P=0.003;OR=0.659,95%CI 0.506-0.859,P=0.002;OR=0.817,95%CI 0.692-0.966,P=0.018)].Spearman rank correlation analysis showed that serum IL-33 level and rCBF values in the periventricular area and centrum semiovale were negatively correlated with the severity of WMILs(r=-0.575,P<0.01;r=-0.607,P<0.01;r=-0.644,P<0.01).Conclusion The IL-33 level and rCBF values in the periventricular area and centrum semiovale may be related to the severity of WMILs.

关 键 词：脑白质病变 IL-33 脑血流量 相关性 

分 类 号：R742[医药卫生—神经病学与精神病学]