脑卒中后认知功能障碍与炎症反应及线粒体动力相关蛋白的相关性  

Relationship between cognitive dysfunction and inflammation and mitochondrial dynamic associated protein after stroke

作　　者：宋庆云 吴文娟 刘小娟 郭莹[2] 刘春玲[2] 王友明[2] SONG Qingyun;WU Wenjuan;LIU Xiaojuan;GUO Ying;LIU Chunling;WANG Youming(Handan People’s Hospital,Handan 056001,China;Affiliated Hospital of Hebei University of Engineering,Handan 056001,China)

机构地区：[1]邯郸市人民医院,河北邯郸056001 [2]河北工程大学附属医院,河北邯郸056001

出　　处：《中国实用神经疾病杂志》2024年第12期1567-1572,共6页Chinese Journal of Practical Nervous Diseases

基　　金：2024年度河北省医学科学研究课题计划项目(编号:20242092)。

摘　　要：目的探讨脑卒中后认知功能障碍(PSCI)与炎症反应及线粒体动力相关蛋白(DRP1)的相关性。方法选取2020-05—2023-08邯郸市人民医院PSCI患者60例为研究对象,收集同期卒中后不伴认知功能障碍(PSNCI)患者100例作对照。收集并比较所有研究对象的基线资料及实验室指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、纤维蛋白原(FIB)及线粒体动力相关蛋白(DRP1)]水平。采用Logistic回归法分析脑卒中后并发认知功能障碍的影响因素。绘制ROC曲线分析IL-6、CRP、FIB及DRP1预测PSCI的效能。结果认知功能障碍组IL-6、CRP、FIB水平均显著高于认知功能正常组,DRP1相对表达量显著低于认知功能正常组(P<0.05)。认知功能障碍组年龄≥70岁、合并疾病(高血压、糖尿病及高脂血症)、吸烟、饮酒、文盲、无体育锻炼及卒中后情绪障碍比重均大于认知功能正常组(P<0.05)。2组性别及体重指数(BMI)比较无统计学差异(P>0.05)。Logistic回归分析显示,年龄≥70岁、高血压、糖尿病、吸烟、文盲,IL-6、CRP、FIB水平升高及DRP1水平降低是脑卒中并发认知功能障碍的独立危险因素(P<0.05)。IL-6、CRP、FIB及DRP1单独预测PSCI的AUC值分别为0.793(95%CI:0.724~0.861)、0.819(95%CI:0.745~0.893)、0.870(95%CI:0.816~0.924)及0.803(95%CI:0.733~0.873),诊断效能较好。四者联合预测PSCI的AUC值为0.975(95%CI:0.955~0.995),四者联合诊断预测PSCI的效能优于IL-6(Z=5.433,P<0.001)、CRP(Z=4.384,P<0.001)、FIB(Z=4.182,P<0.001)及DRP1(Z=5.050,P<0.001)单独诊断。结论IL-6、CRP、FIB及DRP1均与PSCI密切相关,是脑卒中后发生PSCI的独立影响因素,且能有效预测PSCI。Objective To investigate the relationship between post-stroke cognitive impairment(PSCI)and inflammation and mitochondrial dynamic associated protein(DRP1)after stroke.Methods Sixty patients with PSCI in Handan People’s Hospital from May 2020 to August 2023 were selected as the subjects.At the same time,100 patients with post stroke with post-stroke non-cognitive impairment(PSNCI)were collected as controls.Baseline data and laboratory indicators(interleukin-6(IL-6),C-reactive protein(CRP),fibrinogen(FIB)and mitochondrial dynamic-related protein(DRP1))levels were collected and compared in all subjects.Logistic regression was used to analyze the influencing factors for cognitive dysfunction after stroke.ROC diagram was drawn to analyze the efficacy of IL-6,CRP,FIB and DRP1 in predicting PSCI.Results The levels of IL-6,CRP and FIB in cognitive dysfunction group were significantly higher than those in normal cognitive function group,and the relative expression of DRP1 was significantly lower than that in normal cognitive function group(P<0.05).The proportion of age≥70 years old,comorbidities(hypertension,diabetes and hyperlipidemia),smoking,drinking,illiteracy,no physical exercise and mood disorder after stroke in the cognitive dysfunction group was higher than that in the normal cognitive function group(P<0.05).There were no significant differences in gender and BMI between the two groups(P>0.05).Logistic regression analysis showed that age≥70 years old,hypertension,diabetes,smoking,illiteracy,elevated IL-6,CRP,FIB and decreased Drp1 levels were independent risk factors for stroke complicated with cognitive dysfunction(P<0.05).The AUC value of IL-6,CRP,FIB and DRP1 independently predicted PSCI was 0.793(95%CI:0.724-0.861),0.819(95%CI:0.745-0.893),0.870(95%CI:0.816-0.924)and 0.803(95%CI:0.733-0.873),respectively,the diagnostic efficiency was better.The AUC value of PSCI predicted by the four parties was 0.975(95%CI:0.95-0.995),the combined diagnosis of PSCI was superior to IL-6(Z=5.433,P<0.001),CRP(Z=4.384,P<0.

关 键 词：脑卒中 认知功能障碍 炎症反应 线粒体动力相关蛋白 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]