脑小血管病患者血清神经丝轻链蛋白与脑白质高信号及认知损害的相关性研究  

The Correlation between Serum Neurofilament Light Chain Protein and White Matter High Signal and Cognitive Dysfunction in Patients with Small Cerebral Vascular Disease

作　　者：杨姌姌 宋景贵[2] 齐梦茹 韩雪 范琪 张津通 张平[1] YANG Ranran;SONG Jing-gui;QI Meng-ru;HAN Xue;FAN Qi;ZHANG Jin-tong;ZHANG Ping(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;The Second Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院,新乡453000 [2]新乡医学院第二附属医院,新乡453000

出　　处：《中国临床神经科学》2023年第6期656-662,708,共8页Chinese Journal of Clinical Neurosciences

基　　金：P38/MAPK通路调控大鼠中枢神经炎症参与卒中后抑郁机制的研究(编号:222102310450)。

摘　　要：目的 探究脑小血管病(CSVD)患者血清神经丝轻链蛋白(NFL)与脑白质高信号(WMH)和血管性认知损害(VCI)的相关性。方法 纳入2021年6月至2022年6月在新乡医学院第一附属医院神经内科住院的151例血管源性WMH患者作为研究对象,依据简易智能评估量表(MMSE)、蒙特利尔认知评估量表(MoCA)分为血管性认知损害69例(VCI组)和无血管性认知损害82例(N-VCI组)。比较两组患者的一般资料,采用酶联免疫吸附法检测两组血清NFL水平,并使用Fazekas量表对WMH严重程度进行评分。结果 VCI组血清NFL水平为(54.56±7.95)pg·mL^(-1),显著高于N-VCI组(35.09±6.73)pg·mL^(-1),VCI组Fazekas评分[M(IQR)]为[5(4,6)]明显高于N-VCI[2(1,2)],差异均有统计学意义(均P<0.05)。Logistic回归分析示血清NFL水平是VCI的影响因素(OR=1.493,95%CI:1.301~1.713,P=0.001)。相关分析结果显示:血清NFL水平与MoCA评分呈负相关(r=-0.305,P=0.011),与Fazekas量表总分、脑室旁及深部白质评分呈正相关(分别r=0.895、0.779、0.806,均P<0.001)。趋势性卡方检验结果示,随着不同部位(脑室旁、深部白质)WMH等级的增加,出现VCI的比例升高(P<0.05)。结论 血清NFL与WMH、VCI具有相关性,血清NFL是WMH患者发生VCI的重要影响因素。Aim To investigate the relationship among serum neurofilament light chain protein(NFL),white matter hyperintensity(WMH)in patients with cerebral small vascular disease(CSVD),and cognitive dysfunction(VCI).Methods A total of 151 patients with vasogenic WMH admitted to the department of neurology,the First Affiliated Hospital of Xinxiang Medical College from June 2021 to June 2022 were included as subjects.Based on the Mini-mental State Examination(MMSE)scale,Montreal Cognitive Assessment Scale(MoCA),the patients were divided into two groups,a vascular cognitive impairment(VCI)group(69 cases)and a non-vascular cognitive impairment(N-VCI)group(82 cases).General data of the two groups were compared,serum NFL level of the two groups was detected by enzyme-linked immunosorbent assay,and the WMH severity was scored by Fazekas scale.Results The serum NFL level of VCI group was(54.56±7.95)pg·mL^(-1),which was significantly higher than that of N-VCI group(35.09±6.73)pg·mL^(-1),and the Fazekas score of VCI group was[5(4,6)],which was significantly higher than that of control group[2(1,2)],with statistical significance(P<0.05).Logistic regression analysis showed that serum NFL level was an influential factor in cognitive dysfunction(OR=1.493,95%CI 1.301-1.713,P=0.001).Correlation analysis showed that serum NFL level was negatively correlated with MoCA score(r=-0.305,P=0.011),and positively correlated with total score of Fazekas scale,periventricular and deep white matter score(r=0.895,0.779,0.806,all P<0.001).Trend Chi-square test results showed that with the increase of WMH level in different parts(paraventral and deep white matter),the proportion of cognitive dysfunction increased(P<0.05).Conclusion Serum NFL is associated with high white matter signal and cognitive function.Serum NFL is an important factor affecting cognitive dysfunction in patients with WMH.

关 键 词：神经丝轻链蛋白 脑小血管病 脑白质高信号 血管性认知损害 

分 类 号：R743[医药卫生—神经病学与精神病学]