血清P-选择素、D-二聚体、神经元特异性烯醇化酶水平与急性脑梗死患者认知功能的关系  

Relationship between serum levels of P-selectin,D-D and NSE and cognitive function in patients with acute cerebral infarction

作　　者：胡方方 石瑜 王广军[1] 吕朋 刘旭 Hu Fangfang;Shi Yu;Wang Guangjun(Xuzhou Cancer Hospital,Xuzhou 221000)

机构地区：[1]徐州市肿瘤医院神经内科,江苏徐州221000 [2]徐州新健康老年病医院神经内科,江苏徐州221007

出　　处：《中国现代医药杂志》2023年第8期20-24,共5页Modern Medicine Journal of China

摘　　要：目的探讨血清P-选择素(P-selectin,Ps)、D-二聚体(D-dimer,D-D)、神经元特异性烯醇化酶(Neuronspecific enolase,NSE)水平与急性脑梗死患者认知功能的关系。方法选取我院2019年1月~2022年12月收治的292例急性脑梗死患者为研究对象。入院后于开始治疗前检测血清Ps、D-D、NSE水平,评价认知功能;对比不同神经功能缺损程度患者血清Ps、D-D、NSE水平;分析影响急性脑梗死患者出现认知功能障碍的危险因素。结果不同神经功能缺损程度患者血清Ps、D-D、NSE水平和MMSE评分对比差异均有统计学意义(P<0.05),其中血清Ps、D-D、NSE水平对比,重度>中度>轻度(P<0.05);MMSE评分对比,轻度>中度>重度(P<0.05);292例患者中认知功能障碍发生率为35.62%,发生者年龄>60岁、发病至入院时间>3h、合并原发性高血压、合并2型糖尿病、合并高脂血症、有认知功能障碍家族史、重度与中度神经功能缺损、大脑皮层梗死、额叶/颞叶/顶叶/丘脑梗死、≥2个梗死灶、左侧半球病变、大面积与中等面积脑梗死、血清Ps水平升高、血清D-D水平升高、血清NSE水平升高者构成比均明显高于未发生者(P<0.05),且经Logistic回归分析证实均为急性脑梗死患者发生认知功能障碍的独立危险因素;血清Ps、D-D、NSE水平与MMSE评分均呈负相关(r=-0.715、-0.757、-0.812,P均<0.05)。结论急性脑梗死患者血清Ps、D-D、NSE水平与神经功能缺损程度相关,认知功能障碍发生风险高,且年龄>60岁、血清Ps、D-D、NSE水平升高等均是急性脑梗死患者发生认知功能障碍的独立危险因素。Objective To investigate the relationship between serum levels of P-selectin(Ps),D-dimer(D-D),neuron-specific enolase(NSE)and the cognitive function of patients with acute cerebral infarction.Methods 292 patients with acute cerebral infarction admitted to our hospital from Jan 2019 to Dec 2022 were selected as the objects.The levels of serum Ps,D-D and NSE were detected after admission and before treatment to evaluate cognitive function.The levels of serum Ps,D-D and NSE in patients with different neurological deficits were compared.The risk factors of cognitive function impairment in patients with acute cerebral infarction were analyzed.Results There were significant differences in the levels of serum Ps,D-D,NSE and MMSE of different neurological deficits(P<0.05).The levels of serum Ps,D-D and NSE in patients with severe neurological deficits>moderate>mild(P<0.05),and the score of MMSE in patients with mild neurological deficits>moderate>severe(P<0.05).The incidence of cognitive function impairment was 35.62%in the 292 patients,and the proportions of patients with age over 60 years old,onset time over 3 hours,primary hypertension,type 2 diabetes mellitus,hyperlipidemia,family history of cognitive function impairment,severe and moderate neurological impairment,cerebral cortex infarction,frontal lobe/temporal lobe/parietal lobe/thalamus infarction,greater than or equal to 2 infarctied foci,left hemisphere lesions,massive and moderate cerebral infarction,elevated level of serum Ps,D-D and NSE in patients with cognitive function impairment were higher than patients without cognitive function impairment(P<0.05),which were confirmed risk factors for cognitive function impairment(P<0.05).Serum Ps,D-D,NSE levels were negatively correlated with MMSE scores(r=-0.715,-0.757,-0.812,all P<0.05).Conclusion The serum levels of Ps,D-D and NSE in patients with acute cerebral infarction are correlated with the degree of neurological deficits,indicating a high risk cognitive function impairment.Age over 60 years old,elevated serum

关 键 词：P-选择素 D-二聚体 神经元特异性烯醇化酶 急性脑梗死 认知功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]