AQP4 MMP-9及白质缺血性病变与脑出血后认知功能障碍及预后的相关性  

Correlation of AQP4 MMP-9 and white matter ischemic lesions with cognitive dysfunction and prognosis after cerebral hemorrhage

作　　者：高灵利[1] 方建[1] 李延红[1] 李晓晖[1] 耿智凡 GAO Lingli;FANG Jian;LI Yanhong;LI Xiaohui;GENG Zhifan(The First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院,河南开封475000

出　　处：《中国实用神经疾病杂志》2025年第2期207-212,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:LH-GJ20210555);开封市科技局项目(编号:2003033)。

摘　　要：目的探究AQP4、MMP-9、白质缺血性病变与脑出血后认知功能障碍及预后的相关性。方法选取2019-10—2022-12河南大学第一附属医院神经内科收治的50例脑出血患者伴认知功能障碍患者为观察组,另选取50例脑出血但认知功能无异常改变的患者为对照组。采用ELISE法检测水通道蛋白4(AQP4)、基质金属蛋白酶9(MMP-9),采用NIHSS、简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)等评估患者的神经功能、认知损伤等,采用Pearson相关系数对相关性进行分析,依据NIHSS评定伴认知功能障碍患者的预后,并对影响认知功能障碍患者预后的相关因素进行Logistic回归分析。结果与对照组相比,观察组AQP4、MMP-9水平和NIHSS评分、白质缺血性病变评分均显著升高,MMSE、MoCA评分显著降低,差异均有统计学意义(t=35.890、36.340、4.179、12.570、33.390、5.138,P<0.05)。经Pearson相关分析,在伴脑出血后认知功能障碍患者中,NIHSS评分与AQP4、MMP-9、血肿体积、病变严重程度、白质缺血性病变评分呈正相关,MMSE、MoCA评分与AQP4、MMP-9、血肿体积、病变严重程度、白质缺血性病变评分等均呈明显负相关。预后不良组患者的NIHSS评分、AQP4、MMP-9、白质缺血性病变评分等均高于预后良好组(P<0.05),Logistic回归模型分析显示,病变严重程度、Hcy、血肿体积、白质缺血性病变评分、AQP4、MMP-9、NIHSS评分、MMSE评分、MoCA评分等均是认知功能障碍预后不良的危险因素。结论AQP4、MMP-9及白质缺血性病变异常均与脑出血后认知功能障碍及不良预后存在相关性。Objective To investigate the correlations among AQP4,MMP-9,white matter ischemic lesions and cognitive dysfunction and prognosis after cerebral hemorrhage.Methods Fifty patients with cerebral hemorrhage with cognitive dysfunction admitted to the Department of Neurology of the First Affiliated Hospital of Henan University from October 2019 to December 2022 were selected as the observation group,and another 50 patients with cerebral hemorrhage without abnormal changes in cognitive function were selected as the control group.Aquaporin 4(AQP4)and matrix metalloproteinase 9(MMP-9)were detected by ELISE method.NIHSS,mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)were used to assess the neurological function and cognitive impairment.Pearson correlation coefficient was used to analyze the correlation.The prognosis of patients with cognitive impairment was evaluated according to NIHSS,and the related factors affecting the prognosis of patients with cognitive impairment were analyzed by Logistic regression.Results Compared with the control group,AQP4 and MMP-9 levels,NIHSS and white matter ischemic lesion scores in the observation group increased significantly,while MMSE and MoCA scores decreased significantly,with statistical significance(t=35.890,36.340,4.179,12.570,33.390,5.138,respectively,P<0.05).According to Pearson correlation analysis,NIHSS score was positively correlated with AQP4,MMP-9,hematoma volume,lesion severity,and white matter ischemic lesion score in patients with cognitive dysfunction after intracerebral hemorrhage.MMSE and MoCA scores were negatively correlated with AQP4,MMP-9,hematoma volume,lesion severity and white matter ischemic lesion score.NIHSS scores,AQP4,MMP-9 and white matter ischemic lesion scores in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Logistic regression model analysis showed that lesion severity,Hcy,hematoma volume,white matter ischemic lesion score,AQP4,MMP-9,NIHSS,MMSE and MoCA scores were all risk factors for poo

关 键 词：脑出血 认知功能障碍 水通道蛋白4 基质金属蛋白酶9 白质缺血性病变 预后 

分 类 号：R749.13[医药卫生—神经病学与精神病学]