脑小血管病患者血清可溶性髓样细胞触发受体2和巨噬细胞游走抑制因子水平与脑白质病变程度及认知障碍的相关性  

Correlation of serum soluble triggering receptor expressed on myeloid cells-2and macrophage migration inhibitory factor levels with brain white matter lesions severity and cognitive impairment in patients with cerebral small vascular disease

作　　者：殷椿茂 牛延良[1] 李丽媛[1] 杨帅凯 YIN Chunmao;NIU Yanliang;LI Liyuan;YANG Shuaikai(Department of the Second Ward of Neurology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450015,China)

机构地区：[1]郑州大学第五附属医院神经内科二病区,河南郑州450015

出　　处：《社区医学杂志》2024年第18期621-626,共6页Journal Of Community Medicine

摘　　要：目的探讨脑小血管病(CSVD)患者血清可溶性髓样细胞触发受体2(sTREM2)和巨噬细胞游走抑制因子(MIF)水平与脑白质病变(WML)程度,以及两者与认知障碍的相关性。方法选取2021-04-16-2023-04-21郑州大学第五附属医院进行治疗的89例CSVD患者作为观察组,选择同期89名健康体检者作为对照组。根据Fazekas视觉评分法将CSVD患者分为轻度WML组(n=29)、中度WML组(n=39)和重度WML组(n=21);根据蒙特利尔认知评价量表(MoCA)评分法将CSVD患者分为认知功能障碍组(n=36)和认知功能正常组(n=53);比较各组血清sTREM2、MIF水平;Spearman法分析CSVD患者血清sTREM2、MIF水平与MoCA评分的相关性;受试者工作特征(ROC)曲线分析血清sTREM2、MIF水平对CSVD患者认知功能障碍的诊断价值。结果观察组血清sTREM2、MIF分别为(3.22±1.04)μg/L和(52.45±15.22)ng/mL,高于对照组,差异有统计学意义,t值分别为16.615和15.810,均P<0.001;重度WML组、中度WML组、轻度WML组血清sTREM2(F=60.764,P<0.001)、MIF(F=45.033,P<0.001)水平依次降低,差异有统计学意义。认知功能障碍组患者血清sTREM2水平为(4.25±1.38)μg/L,高于认知功能正常组(2.52±0.81)μg/L,t=7.443,P<0.001;MIF水平为(68.81±21.75)ng/mL,高于认知功能正常组(41.34±14.36)ng/mL,t=7.183,P<0.001。Spearman法分析结果显示,CSVD患者血清sTREM2、MIF水平与MoCA评分均呈负相关,r值分别为-0.652和-0.697,均P<0.001;血清sTREM2、MIF以及两者联合诊断CSVD患者认知功能障碍的曲线下面积(AUC)分别为0.86、0.82和0.93,联合诊断的灵敏度为88.89%,特异度为88.68%,两者联合优于血清sTREM2、MIF各自单独诊断,Z值分别为2.148和2.521,P值分别为0.032和0.012。结论CSVD患者血清sTREM2、MIF水平呈高表达,与WML程度、认知障碍密切相关,两者联合对CSVD患者认知功能障碍具有较高的诊断效能,可作为临床监测的重要指标。Objective To investigate the correlation between serum levels of soluble triggering receptor expressed on myeloid cells-2(sTREM2)and macrophage migration inhibitory factor(MIF)with brain white matter lesions(WML)severity and cognitive impairment in patients with cerebral small vascular disease(CSVD).Methods Totally 89CSVD patients treated at the Fifth Affiliated Hospital of Zhengzhou University from April 16,2021to April 21,2023were selected as the observation group,and 89healthy individuals who underwent physical examinations during the same period were selected as the control group.According to the Fazekas visual scoring system,CSVD patients were grouped into mild WML group(n=29),moderate WML group(n=39),and severe WML group(n=21);according to the Montreal cognitive assessment(MoCA)scoring method,CSVD patients were grouped into a cognitive impairment group(n=36)and a cognitive normal group(n=53);the serum levels of sTREM2and MIF in each group were compared;Spearman method was applied to analyze the correlation between serum sTREM2,MIF levels and MoCA score in CSVD patients;receiver operating characteristic(ROC)was applied to analyze the diagnostic value of serum sTREM2and MIF levels for cognitive impairment in patients with CSVD.Results The serum levels of sTREM2and MIF in the observation group were(3.22±1.04)μg/L and(52.45±15.22)ng/ml,respectively,which were higher than those in the control group(t values were 16.615and 15.810,all P<0.001);the serum levels of sTREM2and MIF in severe WML group,moderate WML group and mild WML group were decreased,and the differences were statistically significant(F values were 60.764and 45.033,all P<0.001);the serum levels of sTREM2and MIF in cognitive impairment group were(4.25±1.38)μg/L and(68.81±21.75)ng/ml,respectively,which were obviously higher than those in cognitive normal group(2.52±0.81)μg/L and(41.34±14.36)ng/ml(t values were 7.443and 7.183,all P<0.001);Spearman analysis showed that the serum levels of sTREM2and MIF in CSVD patients were negatively correlated

关 键 词：脑小血管病 可溶性髓样细胞触发受体2 巨噬细胞游走抑制因子 脑白质病变 认知障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]