老年缺血性脑卒中患者血清Egr-1、Neuregulin 1表达水平对血管性痴呆的预测效能  

Predictive effect of serum Egr-1 and Neuregulin 1 expression levels on vascular dementia in elderly patients with ischemic stroke

作　　者：涂艳[1] 王丽平[2] TU Yan;WANG Liping(Department of Geriatrics,Tongji Medical College,HuazhongUniversity of Science and Technology,Wuhan,Hubei 430000,China;Department of Neurology,Liyuan Hospital,Tongji Medical College,HuazhongUniversity of Science and Technology,Wuhan,Hubei 430000,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院老年病科,湖北武汉430000 [2]华中科技大学同济医学院附属梨园医院神经内科,湖北武汉430000

出　　处：《国际检验医学杂志》2023年第19期2385-2389,共5页International Journal of Laboratory Medicine

基　　金：2019年国家社科基金后期资助项目(19FRKB002)。

摘　　要：目的分析老年缺血性脑卒中患者血清早期生长反应因子1(Egr-1)、神经调节蛋白1(NRG1)表达水平对血管性痴呆(VD)的预测效能。方法将2019年5月至2022年3月该院收治的122例老年缺血性脑卒中患者作为研究对象,随后根据治疗后6个月内是否发生血管性痴呆分为痴呆组(n=55)、非痴呆组(n=67),根据简易精神状态评价量表(MMSE)评分将痴呆组患者分为轻度组、中度组、重度组。采用酶联免疫吸附试验检测血清Egr-1、NRG1表达水平,比较各组血清Egr-1、NRG1表达水平;采用受试者工作特征(ROC)曲线分析血清Egr-1、NRG1对老年缺血性脑卒中患者血管性痴呆的预测效能,采用多因素Logistic回归分析影响缺血性脑卒中患者发生血管性痴呆的危险因素。结果痴呆组患者血清Egr-1表达水平明显高于非痴呆组,NRG1表达水平明显低于非痴呆组,差异有统计学意义(P<0.05)。血管性痴呆患者重度组血清Egr-1表达水平明显高于中度组,中度组高于轻度组,差异有统计学意义(P<0.05),NRG1表达水平明显低于中度组、轻度组,中度组低于轻度组,差异有统计学意义(P<0.05)。ROC曲线结果显示,血清Egr-1联合NRG1预测老年缺血性脑卒中患者发生血管性痴呆的曲线下面积(AUC)为0.925,高于血清Egr-1(AUC=0.874)、NRG1(AUC=0.785)单独预测。多因素Logistic回归分析显示,血清Egr-1≥1.63 pg/mL(OR=3.404,95%CI:1.906~6.081)、NRG1<12.66 pg/mL(OR=2.795,95%CI:1.709~4.572)为影响老年缺血性脑卒中患者血管性痴呆发生的危险因素(P<0.05)。结论血清Egr-1表达水平在老年缺血性脑卒中血管性痴呆患者中异常升高,而血清NRG1异常降低,且二者表达水平与患者血管性痴呆严重程度密切相关,同时对缺血性脑卒中患者血管性痴呆的发生有良好的预测效能。Objective To explore the predictive effect of serum early growth response factor 1(Egr-1)and Neuregulin 1(NRG1)expression levels on vascular dementia(VD)in senile ischemic stroke.Methods A total of 122 elderly patients with ischemic stroke admitted to this hospital from May 2019 to March 2022 were selected as research objects,and divided into dementia group(n=55)and non-dementia group(n=67)according to whether VD occurred within 6 months after treantment.In addition,the dementia group was divided into mild group,moderate group and severe group according to the MMSE scores.The serum expression levels of Egr-1 and NRG1 were detected by enzyme-linked immunosorbent assay(ELISA)and the levels were compared among the groups.The predictive efficacy of serum Egr-1 and NRG1 on VD in patients with ischemic stroke was analyzed by ROC,and the risk factors affecting VD in patients with ischemic stroke was analyzed by multivariate Logistic regression.Results The serum Egr-1 level in dementia group was higher than that in non-dementia group,the level of NRG1 was lower than that in non-dementia group,with statistical significance(P<0.05).The level of serum Egr-1 in the severe group was significantly higher than that in the moderate group,and the moderate group was higher than that in the mild group,with statistical significance(P<0.05).The level of NRG1 was significantly lower than that in the moderate group and the mild group,and the moderate group was lower than that in the mild group,with statistical significance(P<0.05).ROC curve results showed that the area under the curve(AUC)of serum Egr-1 combined with NRG1 in predicting VD in elderly patients with ischemic stroke was 0.925,which was higher than that of serum Egr-1(AUC=0.874)and NRG1(AUC=0.785)alone.Multivariate Logistic regression analysis showed that serum Egr-1≥1.63 pg/mL(OR=3.404,95%CI:1.906-6.081)and NRG1<12.66 pg/mL(OR=2.795,95%CI:1.709-4.572)were risk factors for VD in elderly patients with ischemic stroke(P<0.05).Conclusion Serum Egr-1 expression abnormally inc

关 键 词：缺血性脑卒中 血管性痴呆 早期生长反应因子1 神经调节蛋白1 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.13[医药卫生—临床医学]