hs-CRP、Lp-PLA2和S100β与缺血性脑小血管病患者认知障碍的相关性  

Correlation of hs-CRP, Lp-PLA2, and S100β with vascular cognitive impairment in patients with ischemic small vascular disease

作　　者：欧春影[1] 李晓宾[1] 郭靖[1] 许可[1] 王梦 安晓雷[1] Chunying Ou;Xiaobin Li;Jing Guo;Ke Xu;Meng Wang;Xiaolei An(Department of Neurology,Xuzhou Central Hospital,The Xuzhou School of Clinical Medicine of Nanjing Medical University,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院神经内科,南京医科大学徐州临床医学院,江苏徐州221000

出　　处：《中华脑血管病杂志（电子版）》2024年第3期265-269,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：江苏省科技项目(BL2014028);江苏省卫生健康委科研课题(Ym2023012);徐州市科技项目(KC22175)。

摘　　要：目的研究缺血性脑小血管病(CSVD)患者高敏C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A2(Lp-PLA2)和钙结合蛋白S100β与认知障碍的相关性。方法收集2020年6月至2022年6月徐州市中心医院神经内科门诊及住院的缺血性CSVD患者80例作为观察组,采用蒙特利尔认知评估(MoCA)量表对受试者认知功能进行评分,并根据评分将缺血性CSVD患者分为非认知障碍组和认知障碍组。选择同期40例健康体检者作为健康对照组。测定缺血性CSVD患者及健康体检者血清中hs-CRP、Lp-PLA2和S100β的水平。采用单因素方差分析3组hs-CRP、Lp-PLA2和S100β的差异并采用Scheffe法进行组间两两比较,然后进行Logistic多因素回归分析,采用Spearman相关分析各独立影响因素与MoCA评分的相关性。结果认知障碍组患者(48例)血清中hs-CRP[(7.6±4.01)ng/ml]、Lp-PLA2[(55.77±35.59)pg/ml]、S100β[(0.66±0.047)μg/L]均高于非认知障碍组[32例,(4.35±3.99)ng/ml、(37.71±8.45)pg/ml、(0.62±0.058)μg/L]和对照组[(1.13±0.84)ng/ml、(24.10±3.16)pg/ml、(0.56±0.039)μg/L],差异均具有统计学意义(P均<0.05)。Logistic回归分析显示,血清hs-CRP、Lp-PLA2、S100β是缺血性CSVD患者认知障碍的独立危险因素(OR=2.619,P<0.001;OR=1.814,P<0.001;OR=2.340,P<0.001);hs-CRP、Lp-PLA2、S100β与MoCA评分均呈负相关(r=-0.533,P<0.001;r=-0.263,P=0.018;r=-0.369,P=0.009)。结论hs-CRP、Lp-PLA2、S100β与CSVD患者认知功能呈负相关,是其独立危险因素。Objective To investigate the correlation between high sensitivity C-reactive protein (hs-CRP), lipoprotein-associated phospholipase A2 (Lp-PLA2), and calcium-binding protein β (S100β) and cognitive impairment in patients with ischemic small cerebral vascular disease (CSVD).MethodsA total of 80 patients with ischemic CSVD were collected as observation group and were divided into non-cognitive impairment and cognitive impairment groups according to the score of Montreal cognitive assessment (MoCA). An additional 40 healthy people were selected as the healthy control group. Serum levels of hs-CRP, Lp-PLA2, and S100β in patients with ischemic CSVD and healthy people were measured. The levels of hs-CRP, Lp-PLA2, and S100β were analyzed using one-way Anova, followed by Logistic multiple regression analysis and Spearman correlation analysis to determine their correlation.ResultsThere were no significant differences in general conditions among the three groups. The serum levels of hs-CRP, Lp-PLA2, and S100β in patients with cognitive impairment [(7.6±4.01) ng/ml, (55.77±35.59) pg/ml, (0.66±0.047) μg/L] were higher than those in patients without cognitive impairment [(4.35±3.99) ng/ml, (37.71±8.45) pg/ml, (0.62±0.058) μg/L] and in healthy controls [(1.13±0.84) ng/ml, (24.10±3.16) pg/ml, (0.56±0.039) μg/L]. Logistic regression analysis showed that serum hs-CRP, Lp-PLA2, and S100β were independent risk factors for cognitive impairment in patients with CSVD (OR=2.619, P<0.001;OR=1.814, P<0.001;OR=2.340, P<0.001). hs-CRP, Lp-PLA2, and S100β were negatively correlated with MoCA scores (r=-0.533, r=-0.263, r=-0.369;all P<0.05).Conclusionhs-CRP, Lp-PLA2, S100β were negatively correlated with the cognitive function in CSVD and were identified independent risk factors.

关 键 词：脑小血管病 血管性认知障碍 高敏C反应蛋白 脂蛋白相关磷脂酶A2 钙结合蛋白β 

分 类 号：R749.1[医药卫生—神经病学与精神病学]