血清神经元特异性烯醇化酶与卒中急性期认知功能障碍的相关性  

Correlation between serum neuron-specific enolase and cognitive dysfunction after acute stroke

作　　者：王虹[1] 王柳清 王贞[1] 张容闻 雷陈莉 栾晓倩 WANG Hong;WANG Liuqing;WANG Zhen;ZHANG Rongwen;LEI Chenli;LUAN Xiaoqian(Department of Neurology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Neurology,People’s Hospital of Gaochun District,Nanjing 211300,China;The First School of Medicine,Wenzhou Medical University,Wenzhou 325035,China)

机构地区：[1]温州医科大学附属第一医院神经内科,浙江温州325015 [2]南京高淳区人民医院神经内科,江苏南京211300 [3]温州医科大学第一临床学院,浙江温州325035

出　　处：《温州医科大学学报》2024年第6期452-457,共6页Journal of Wenzhou Medical University

基　　金：浙江省自然科学基金项目(LY19H090013);浙江省医药卫生科技计划项目(2020KY637);温州市基础性科研项目(Y2020421)。

摘　　要：目的:探讨卒中急性期认知功能障碍与入院时血清神经元特异性烯醇化酶(NSE)之间的关系。方法:选取2017年7月至2023年1月在温州医科大学附属第一医院神经内科住院的急性缺血性脑卒中(AIS)患者。所有患者在卒中发病后1个月完成简易精神状态检查量表(MMSE)评估。在入院后第2天清晨采集空腹血并完成NSE的检测,血清NSE水平分为四层:Q1:≤11.00 ng/mL,Q2:>11.00~13.50 ng/mL,Q3:>13.50~17.00 ng/mL及Q4:>17.00 ng/mL。通过二元Logistic回归分析探讨血清NSE与卒中急性期认知功能障碍间的关系;采用限制性立方样条图(RCS)进一步探索NSE与认知功能障碍的关系。结果:认知功能障碍组血清NSE水平显著高于非认知功能障碍组(P<0.05)。二元Logistic回归分析显示,在控制了混杂因素后,以Q3层为参照,Q1、Q2及Q4层的患者发生认知功能障碍的风险均显著高于Q3层的患者(P<0.05)。此外,RCS模型发现当血清NSE水平高于17.69 ng/mL时,卒中急性期认知功能障碍的发生风险随着NSE的增加而显著升高;当血清NSE水平低于17.69 ng/mL时,卒中急性期认知功能障碍的发生风险相对稳定。结论:较高的血清NSE水平与卒中急性期认知功能障碍有关。这一发现可能有助于早期识别高风险患者,从而及时进行干预。Objective:To explore the relationship between cognitive impairment in the acute stage of ischemic stroke and the levels of serum neuron-specific enolase(NSE)at admission.Methods:Subjects with acute ischemic stroke(AIS)were screened from the First Affiliated Hospital of Wenzhou Medical University from July 2017 to January 2023.Their cognition status was assessed by the Mini-Mental State Examination(MMSE)within the first month after stroke.Blood samples were obtained in the morning for measuring the levels of NSE,which were divided into four quartiles:Q1:≤11.00 ng/mL,Q2:>11.00-13.50 ng/mL,Q3:>13.50-17.00 ng/mL,and Q4:>17.00 ng/mL.To investigate the relationship between NSE and PSCI,binary logistic regression analysis was conducted.Additionally,a restricted cubic spline(RCS)model was employed to further investigate the connection between NSE and cognitive impairment in the acute stage of ischemic stroke.Results:The serum NSE levels were significantly higher in the PSCI group(P<0.05).With confounders adjusted,the risk of developing cognitive impairment was significantly higher for patients in the Q1,Q2 and Q4 quartiles compared with those in the Q3 quartile(P<0.05 for all).Additionally,the restricted cubic spline(RCS)model indicated that the risk of cognitive impairment in the acute stage of ischemic stroke escalated markedly with the increase of serum NSE levels once they surpassed the threshold of 17.69 ng/mL.Conclusion:Higher serum NSE levels were associated with cognitive impairment after stroke,which might aid in the early identification of highrisk patients and facilitate timely intervention.

关 键 词：急性缺血性脑卒中 神经元特异性烯醇化酶 认知功能障碍 

分 类 号：R762[医药卫生—耳鼻咽喉科]