血清AGEs、NSE、GST水平与伴T2DM的急性前循环脑梗死并发血管性认知障碍的关系  

Relationship between serum levels of AGEs,NSE,GST and vascular cognitive impairment in acute anterior circulation cerebral infarction with T2DM

作　　者：张豪 王怡静 张亚娟 王小红 何维 李嵩韬 聂莉 赵宗权 ZHANG Hao;WANG Yijing;ZHANG Yajuan;WANG Xiaohong;HE Wei;LI Songtao;NIE Li;ZHAO Zongquan(Department of General Medicine,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou,Jiangsu 215000,China;Department of General Practice,Pingjiang New Town Community Health Service Center,Sujin Street,Gusu District,Suzhou,Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院全科医学科,江苏苏州215000 [2]江苏省苏州市姑苏区苏锦街道平江新城社区卫生服务中心全科医学科,江苏苏州215000

出　　处：《检验医学与临床》2024年第18期2637-2641,2646,共6页Laboratory Medicine and Clinic

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-3-2023-388);江苏省苏州市科技局科研项目(SKJYD2021042,SKY2022088);江苏省苏州市姑苏卫生人才计划资助项目[2020(076)]。

摘　　要：目的探讨血清晚期糖基化终末产物(AGEs)、神经元特异性烯醇化酶(NSE)、谷胱甘肽硫转移酶(GST)水平与伴2型糖尿病(T2DM)的急性前循环脑梗死(AACI)并发血管性认知障碍(VCI)的关系。方法选取2021年1月至2022年12月南京医科大学附属苏州医院收治的185例伴T2DM的AACI患者作为观察组,185例不伴T2DM的AACI患者作为AACI组,另选取同期在南京医科大学附属苏州医院体检的185例健康志愿者作为对照组。采用酶联免疫吸附试验检测受试者血清AGEs、NSE、GST水平对所有患者随访1年,统计观察组和AACI组患者VCI发生率,根据是否并发VCI将观察组患者分为VCI组和非VCI组,比较VCI组和非VCI组临床资料。采用多因素Logistic回归分析伴T2DM的AACI患者并发VCI的危险因素。绘制受试者工作特征(ROC)曲线评估血清AGEs、NSE、GST对伴T2DM的AACI患者并发VCI的预测效能。结果观察组和AACI组血清AGEs、NSE水平高于对照组,且观察组高于AACI组,差异均有统计学意义(P<0.05)。观察组和AACI组血清GST水平低于对照组,且观察组低于AACI组,差异均有统计学意义(P<0.05)。VCI组有73例患者,非VCI组有112例患者。观察组、AACI组VCI的发生率分别为39.46%(73/185)和27.57%(51/185)。观察组VCI发生率高于AACI组(P<0.05)。VCI组患者T2DM病程、发病至入院时间长于非VCI组,入院时美国国立卫生研究院卒中量表(NIHSS)评分、有颈动脉斑块患者比例、合并高血压患者比例、合并高脂血症患者比例及血清AGEs、NSE水平高于非VCI组,血清GST水平低于非VCI组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,T2DM病程延长、入院时NIHSS评分升高、有颈动脉斑块、合并高血压及血清AGEs、NSE水平升高,GST水平降低均是伴T2DM的AACI患者并发VCI的危险因素(P<0.05)。ROC曲线分析结果显示,血清AGEs、NSE、GST联合预测伴T2DM的AACI患者并发VCI的曲线下面积(AUC)为0.947,大于�Objective To investigate the relationship between serum levels of advanced glycation end products(AGEs),neuron-specific enolase(NSE),glutathione thitransferase(GST)and vascular cognitive impairment(VCI)in acute anterior circulation cerebral infarction(AACI)with type 2 diabetes mellitus(T2DM).Methods A total of 185 AACI patients with T2DM admitted to Suzhou Hospital Affiliated to Nanjing Medical University from January 2021 to December 2022 were selected as the observation group,185 AACI patients without T2DM were selected as the AACI group,and 185 healthy volunteers who underwent physical examination in Suzhou Hospital Affiliated to Nanjing Medical University during the same period were selected as the control group.Serum AGEs,NSE and GST levels of the subjects were detected by enzyme-related immunosorbent assay.The incidence of VCI in the observation group and AACI group was analyzed during 1-year follow-up.Patients in the observation group were divided into VCI group and non-VCI group according to whether there was concurrent VCI,and clinical data of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of VCI in AACI patients with T2DM.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of serum AGEs,NSE,and GST levels for VCI in AACI patients with T2DM.Results The serum levels of AGEs and NSE in the observation group and AACI group were higher than those in the control group,and which in the observation group were higher than those in the AACI group,with statistical significances(P<0.05).The serum GST level in observation group and AACI group were lower than those in control group,and which in the observation group was lower than that in AACI group,with statistical significances(P<0.05).There were 73 patients in the VCI group and 112 patients in the non-VCI group.The incidence of VCI in observation group and AACI group was 39.46%(73/185)and 27.57%(51/185)respectively.The incidence of VCI in observation group was higher than

关 键 词：晚期糖基化终末产物 神经元特异性烯醇化酶 谷胱甘肽硫转移酶 2型糖尿病 急性前循环脑梗死 血管性认知障碍 

分 类 号：R749.13[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]