急性脑梗死患者侧支循环建立状况下血清PGRN和SDF-1水平与认知功能障碍的相关性研究  

The correlation between serum PGRN and SDF-1 levels and cognitive impairment in patients with acute cerebral infarction under the condition of collateral circulation establishment

作　　者：刘懿[1] 索文岐 史欢欢 LIU Yi;SUO Wen-qi;SHI Huan-huan(Department of Laboratory Medicine,the First Affiliated Hospital of Xi′an Jiaotong University,Shaanxi Province,Xi′an 710061,China;Department of Laboratory Medicine,the Affiliated Hospital of Xi′an Medical College,Shaanxi Province,Xi′an 710309,China;Department of Laboratory Medicine,the Second Affiliated Hospital of Air Force Military Medical University,Shaanxi Province,Xi′an 710000,China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061 [2]西安医学高等专科学校附属医院检验科,陕西西安710309 [3]空军军医大学第二附属医院检验科,陕西西安710038

出　　处：《河北医科大学学报》2024年第6期632-637,共6页Journal of Hebei Medical University

基　　金：陕西省创新能力支撑计划项目(2020PT-007)。

摘　　要：目的 探讨血清颗粒蛋白前体(progranulin, PGRN)及基质细胞衍生因子1(stromal-derived factor-1,SDF-1)水平与急性脑梗死(acute cerebral infarction, ACI)患者支循环建立状况下认知功能障碍的相关性。方法 选择ACI患者130例作为研究对象。依据患者脑侧支循环状态的评估分为侧支循环良好(fine collateral circulation, FCC;72例)组和侧支循环不良(poor collateral circulation, PCC;58例)组。血清PGRN及SDF-1水平采用酶联免疫吸附法检测。认知功能采用蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale, MoCA)评估。比较分析以上指标的变化与急性脑梗死后认知功能障碍的相关性。结果 PCC组SDF-1水平比FCC组增加(t=2.705,P<0.05),PGRN水平降低(t=5.747,P<0.05)。PCC组的MoCA评分低于FCC组(t=5.302,P<0.05)。ACI患者的血清PGRN和SDF-1水平呈负相关性(r=-0.289,P<0.05)。ACI患者的PGRN水平与MoCA评分呈正相关性(r=0.203,P<0.05);SDF-1水平与MoCA评分呈负相关性(r=-0.204,P<0.05)。ACI患者的血清PGRN和SDF-1及联合检测诊断认知功能障碍的曲线下面积分别为0.795(95%CI:0.709~0.888,P<0.01);0.727(95%CI:0.636~0.818,P<0.01);0.805(95%CI:0.727~0.884,P<0.01)。PGRN和SDF-1及联合检测诊断认知功能障碍的敏感度和特异度分别为89.70%和53.40%、63.80%和91.40%、96.60%和51.70%。结论 分析ACI患者在侧支循环不同状况下血清PGRN和SDF-1水平与认知功能障碍的相关性,可以预测认知功能障碍的发生,进一步为认知功能障碍临床干预措施的选择提供理论指导。Objective To investigate the correlation between serum levels of progranulin(PGRN)and stromal derived factor-1(SDF-1)and acute cerebral infarction(ACI)under the condition of collateral circulation establishment.Methods A total of 130 ACI patients were selected as the research subjects.According to the evaluation of the patient′s status of cerebral collateral circulation,they were divided into two groups:fine collateral circulation(FCC;n=72)group and poor collateral circulation(PCC;n=58)group.The levels of serum PGRN and SDF-1 were detected by enzyme-linked immunosorbent assay(ELISA).Cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The correlation between changes in the above indicators and cognitive impairment after ACI was compared and analyzed.Results The SDF-1 level in the PCC group increased compared with the FCC group(t=2.705,P<0.05),while the PGRN level decreased(t=5.747,P<0.05).The MoCA score in the PCC group was lower than that in the FCC group(t=5.302,P<0.05).There was a negative correlation between serum PGRN and SDF-1 levels in ACI patients(r=-0.289,P<0.05).There was a positive correlation between PGRN level and MoCA score in ACI patients(r=0.203,P<0.05),and a negative correlation between SDF-1 level and MoCA score(r=-0.204,P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of serum PGRN and SDF-1 levels detected alone and in combination for the diagnosis of cognitive impairment in ACI patients was 0.795(95%CI:0.709-0.888,P<0.01),0.727(95%CI:0.636-0.818,P<0.01),and 0.805(95%CI:0.727-0.884,P<0.01),respectively.The sensitivity and specificity of PGRN and SDF-1 detected alone and in combination for the diagnosis of cognitive impairment were 89.70%vs.53.40%,63.80%vs.91.40%,and 96.60%vs.51.70%,respectively.Conclusion Analyzing the correlation between serum PGRN and SDF-1 levels and cognitive impairment in patients with ACI under different conditions of collateral circulation can predict the occurrence of cognitive impairment and provide the oretic

关 键 词：脑梗死 侧支循环 认知功能障碍 

分 类 号：R743.33[医药卫生—神经病学与精神病学]