血管性痴呆患者血清HDAC6和BDNF表达与患者认知功能及预后的相关性分析  

Correlation Analysis of Serum HDAC6 and BDNF Expression with Cognitive Function and Prognosis in Patients with Vascular Dementia

作　　者：段新飞 贾俊栋 胡科 房娉平[1] 张英[1] 瞿娟娟 张忠波 Duan Xinfei;Jia Jundong;Hu Ke(Department of Neurology,Handan Central Hospital,Handan,Hebei 056002,China)

机构地区：[1]邯郸市中心医院神经内科,河北邯郸056002

出　　处：《四川医学》2024年第8期848-852,共5页Sichuan Medical Journal

基　　金：河北省2020年度医学科学研究计划(编号:20200452)。

摘　　要：目的探究血管性痴呆(VD)患者血清组蛋白脱乙酰基酶6(HDAC6)和脑源性神经营养因子(BDNF)表达与患者认知功能及预后的相关性。方法选取2020年10月至2022年12月我院收治的126例VD患者为研究对象(VD组),另选取同期在我院治疗但未发生VD的缺血性脑卒中患者100例为对照组。ELISA法测定所有受试者血清BDNF、HDAC6水平;根据蒙特利尔认知功能量表(MoCA)评估患者认知功能;比较不同病情程度、不同预后患者血清BDNF、HDAC6水平;Pearson相关性分析VD患者血清BDNF、HDAC6水平与MoCA评分之间的关系;受试者工作特征(ROC)曲线分析血清BDNF、HDAC6水平对Ⅲ级预后功能障碍的预测价值。结果与对照组相比,VD组患者血清BDNF水平显著降低(P<0.05),HDAC6水平显著升高(P<0.05)。Pearson相关性分析结果显示,血清BDNF与MoCA评分呈显著正相关(r=0.488,P<0.05),血清HDAC6与MoCA评分呈显著负相关(r=-0.490,P<0.05)。与Ⅰ级组相比,Ⅱ级、Ⅲ级组患者血清BDNF水平显著降低(P<0.05),且Ⅲ级组显著低于Ⅱ级组(P<0.05),而HDAC6水平显著升高(P<0.05),且Ⅲ级组显著高于Ⅱ级组(P<0.05)。ROC曲线结果显示,BDNF、HDAC6预测Ⅲ级预后功能障碍的曲线下面积(AUC)分别为0.906(95%CI 0.848~0.965)、0.905(95%CI 0.847~0.964),敏感度分别为95.5%、95.5%,特异度分别为74.3%、70.5%,二者联合预测Ⅲ级预后功能障碍的AUC为0.977(95%CI 0.940~1.000),敏感度为90.9%,特异度为89.9%。结论VD患者血清BDNF水平显著降低,HDAC6水平显著升高,且二者均与患者认知功能障碍及预后密切相关,可为临床诊治提供一定参考。Objective To investigate the correlation between the expression of serum histone deacetylase 6(HDAC6)and brain derived neurotrophic factor(BDNF)in patients with vascular dementia(VD)and their cognitive function and prognosis.Methods A total of 126 patients with VD who underwent treatment in our hospital from October 2020 to December 2022 were collected as the study subjects(VD group),another 100 patients with ischemic brain stroke who were treated in our hospital at the same period but did not develop VD were collected as the control group.ELISA method was applied to measure the serum levels of BDNF and HDAC6 in all subjects;Montreal Cognitive Function Scale(MoCA)was applied to assess cognitive function;the serum levels of BDNF and HDAC6 were compared among patients with different degrees of illness and prognosis;Pearson correlation was applied to analyze the relationship between serum BDNF,HDAC6 levels and MoCA score in VD patients;Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum BDNF and HDAC6 levels for gradeⅢprognostic dysfunction.Results Compared with the control group,the serum BDNF level in the VD group was obviously lower(P<0.05),while the HDAC6 level was obviously higher(P<0.05).Pearson correlation analysis showed that serum BDNF was obviously positively correlated with MoCA score(r=0.488,P<0.05),while serum HDAC6 was obviously negatively correlated with MoCA score(r=-0.490,P<0.05).Compared with the gradeⅠgroup,the serum BDNF level in the gradeⅡandⅢgroups were obviously lower(P<0.05),and the gradeⅢgroup was obviously lower than the gradeⅡgroup(P<0.05),the HDAC6 level was obviously higher(P<0.05),and the gradeⅢgroup was obviously higher than the gradeⅡgroup(P<0.05).ROC curve results showed that the area under the curve(AUC)of BDNF and HDAC6 in predicting gradeⅢprognostic dysfunction was 0.906(95%CI 0.848~0.965)and 0.905(95%CI 0.847~0.964),respectively,with sensitivity of 95.5%and 95.5%,specificity of 74.3%and 70.5%,respectively.The AUC of t

关 键 词：血管性痴呆 组蛋白脱乙酰基酶6 脑源性神经营养因子 认知功能 预后 相关性 

分 类 号：R743[医药卫生—神经病学与精神病学]