外周血Lp-PLA2和FGF23水平变化与脑梗死后认知功能障碍的相关性  

Correlation of Lp-PLA2 and FGF23 levels in peripheral blood and cognitive dysfunction in patients with cerebral infarction

作　　者：马晓伟[1] 田伟[1] 冯文霞[1] 王立哲[1] 张璇[1] MA Xiaowei;TIAN Wei;FENG Wenxia;WANG Lizhe;ZHANG Xuan(Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院,河北邯郸056001

出　　处：《中国实用神经疾病杂志》2024年第4期463-467,共5页Chinese Journal of Practical Nervous Diseases

基　　金：邯郸市科学技术研究与发展计划项目(编号:19422083009-2)。

摘　　要：目的分析外周血脂蛋白相关磷脂酶A2(Lp-PLA2)、成纤维细胞生长因子23(FGF23)水平变化与脑梗死后患者认知功能障碍的相关性。方法选取2019-04—2022-12邯郸市中心医院收治的160例脑梗死患者为研究对象,根据患者是否发生认知功能障碍分为认知障碍组和非认知障碍组,对比2组基线资料及外周血Lp-PLA2、FGF23水平,并采用Logistic回归分析患者发生认知功能障碍的影响因素,采用Pearson相关性分析外周血Lp-PLA2、FGF23与简易智力状态评价量表(MMSE)评分的关系,采用ROC曲线评估外周血Lp-PLA2、FGF23对脑梗死后患者认知功能障碍的预测价值。结果160例脑梗死患者中,48例(30.00%)发生认知功能障碍。认知障碍组患者的平均年龄、高血压、糖尿病、吸烟、文化程度、MMSE评分及血清Lp-PLA2、FGF23水平等方面与非认知障碍组相比,差异有统计学意义(P<0.05)。Logistic回归分析显示,年龄、高血压、糖尿病、吸烟、文化程度低及血清Lp-PLA2、FGF23水平升高是影响脑梗死后认知功能障碍发生的独立危险因素(P<0.05)。Pearson相关性分析显示,脑梗死患者血清Lp-PLA2、FGF23水平与MMSE评分呈负相关(P<0.05)。ROC曲线显示,Lp-PLA2的曲线下面积为0.770,FGF23的曲线下面积为0.779,联合检测的曲线下面积为0.873(P<0.05),表示两者联合检测可作为评价脑梗死后认知功能障碍的有效指标。结论Lp-PLA2、FGF23在脑梗死后认知功能障碍患者血清中均呈高表达,二者联合检测有助于提高对脑梗死后认知功能障碍的预测价值。Objective To analyze the correlation between the levels of lipoprotein-associated phospholipase A2(Lp-PLA2)and fibroblast growth factor 23(FGF23)in peripheral blood and cognitive dysfunction in patients with cerebral infarction.Methods A total of 160 patients with cerebral infarction admitted to Handan Central Hospital from April 2019 to December 2022 were selected as research objects.The patients were divided into cognitive impairment group and non-cognitive impairment group according to whether they had cognitive dysfunction.Baseline data and peripheral blood Lp-PLA2 and FGF23 levels of the two groups were compared.Logistic regression model was used to analyze the related factors affecting the cognitive dysfunction of patients,and Pearson correlation was used to analyze the relationship between peripheral blood Lp-PLA2,FGF23 and mini-mental state examination(MMSE).ROC curve was used to evaluate the predictive value of peripheral blood Lp-PLA2 and FGF23 for cognitive dysfunction in patients with cerebral infarction.Results Of the 160 patients with cerebral infarction,48(30.00%)had cognitive impairment.The mean age,hypertension,diabetes,smoking,education level,MMSE score,serum Lp-PLA2 and serum FGF23 levels in the cognitive impairment group were significantly different from those in the non-cognitive impairment group(P<0.05).Logistic multivariate regression analysis showed that age,hypertension,diabetes,smoking,low education level,serum Lp-PLA2 level and serum FGF23 level were independent risk factors for the occurrence of cognitive dysfunction after cerebral infarction(P<0.05).The results of Pearson correlation analysis showed that the serum Lp-PLA2 and FGF23 levels were negatively correlated with MMSE scores in patients with cerebral infarction(P<0.05).ROC curve results showed that the area under the curve of Lp-PLA2 was 0.770,the area under the curve of FGF23 was 0.779,and the area under the curve of the combined detection was 0.873(P<0.05),indicating that the combined detection of LP-PLA2 and FGF23 could be u

关 键 词：脑梗死 脂蛋白相关磷脂酶A2 成纤维细胞生长因子23 血清 认知功能障碍 危险因素 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]