血清LRG1水平与急性缺血性脑卒中患者认知障碍和卒中复发的关系  

Correlation between serum LRG1 level and cognitive impairment and recurrence in patients with acute ischemic stroke

作　　者：顾亮亮[1] 王建锋[2] 乔鑫 张保朝[1] 傅国惠 GU Liangliang;WANG Jianfeng;QIAO Xin;ZHANG Baochao;FU Guohui(Department of Neurology,Nanyang Central Hospital,Nanyang 473000,Henan,China;Department of General Surgery,Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院神经内科,河南南阳473000 [2]南阳市中心医院普外科,河南南阳473000

出　　处：《检验医学》2024年第5期443-448,共6页Laboratory Medicine

基　　金：河南省医学科技攻关计划项目(192102310326);河南省医学科技攻关计划项目(192102310349)。

摘　　要：目的探讨血清富亮氨酸α-2糖蛋白-1(LRG1)水平在判断急性缺血性脑卒中(AIS)患者认知障碍中的价值及其与卒中复发的关系。方法选取2020年1月—2021年10月南阳市中心医院AIS患者125例,收集所有患者的临床资料和同型半胱氨酸(Hcy)、血脂检测结果,并检测血清LRG1水平。依据蒙特利尔认知评估量表(MoCA)将患者分为认知障碍组(MoCA评分<26分)和无认知障碍组(MoCA评分≥26分)。依据6个月后的卒中复发情况分为复发组和未复发组。采用Pearson相关分析或Spearman相关分析评估LRG1与其他指标的相关性。采用多因素Logistic回归分析评估AIS患者发生认知障碍的危险因素。采用受试者工作特征(ROC)曲线评价各项指标判断AIS患者发生认知障碍和卒中复发的效能。结果认知障碍组总胆固醇(TC)水平和高血脂所占比例均显著高于无认知障碍组(P<0.05),LRG1和高密度脂蛋白胆固醇(HDL-C)水平均显著低于无认知障碍组(P<0.001),其他临床资料2个组之间差异均无统计学意义(P>0.05)。Pearson相关分析和Spearman相关分析结果显示,发生认知障碍的AIS患者血清LRG1与HDL-C呈正相关(r=0.497,P<0.05),与高血脂、TC呈负相关(r值分别为-0.492、-0.486,P<0.05)。多因素Logistic回归分析结果显示,LRG1和HDL-C水平降低是AIS患者发生认知障碍的危险因素[比值比(OR)值分别为0.845、0.876,95%可信区间(CI)分别为0.748~0.954、0.793~0.968,P<0.05]。ROC曲线分析结果显示,血清LRG1、HDL-C单项检测和联合检测判断AIS患者发生认知障碍的曲线下面积(AUC)分别为0.840、0.670、0.851。复发组血清LRG1和HDL-C水平均低于未复发组(P<0.05),TC水平和高血脂所占比例均高于未复发组(P<0.05);ROC曲线分析结果显示,血清LRG1、HDL-C、TC单项检测和联合检测判断AIS患者卒中复发的AUC分别为0.781、0.696、0.806、0.899。结论血清LRG1水平与AIS患者认知障碍和卒中复发有关,或可作为此类患Objective To investigate the role of leucine-rich alpha-2 glycoprotein-1(LRG1)level in cognitive impairment and its relationship with recurrence in patients with acute ischemic stroke(AIS).Methods A total of 125 patients with AIS admitted to Nanyang Central Hospital from January 2020 to October 2021 were enrolled,the clinical data and the results of homocysteine(Hcy)and blood lipid determinations for all the patients were collected,and serum LRG1 levels were determined.The research subjects were classified into cognitive impairment group[Montreal Cognitive Assessment(MoCA)<26]and non-cognitive impairment group(MoCA≥26)according to MoCA scale.They were classified into recurrence group and non-recurrence group based on the stroke recurrence situation after 6 months.Pearson or Spearman correlation was performed to analyze the correlation between serum LRG1 level and other indicators.Multivariate Logistic regression was performed to analyze the influencing factors of cognitive impairment in AIS patients.The efficacy of various indicators in predicting cognitive impairment and stroke recurrence in AIS patients was evaluated by receiver operating characteristic(ROC)curve.Results Total cholesterol(TC)level and the proportion of hyperlipidemia in cognitive impairment group were higher than those in non-cognitive impairment group(P<0.05),while the levels of LRG1 and high-density lipoprotein cholesterol(HDL-C)were lower than those in non-cognitive impairment group(P<0.001).There was no statistical significance in the other clinical data between the 2 groups(P>0.05).Serum LRG1 levels in AIS patients with cognitive impairment were positively correlated with HDL-C(r=0.497,P<0.05)and were negatively correlated with hyperlipidemia and TC(r values were-0.492 and-0.486,P<0.05).The decrease in LRG1 and HDL-C levels was a risk factor for cognitive impairment in AIS patients[odds ratios(OR)were 0.845 and 0.876,95%confidence intervals(CI)were 0.748-0.954 and 0.793-0.968,respectively,P<0.05].The areas under curves(AUC)for single and

关 键 词：富亮氨酸α-2糖蛋白-1 急性缺血性脑卒中 认知障碍 卒中复发 

分 类 号：R446.1[医药卫生—诊断学]