血清AQP1、Fibulin-5表达水平与老年高血压合并脑白质病变患者病情严重程度的关系  

Relationship between the expression levels of serum AQP1 and Fibulin-5 and the severity of disease in elderly hypertension patients with WML with cerebral white matter lesions

作　　者：李阳阳[1] 方建[2] 王晓雪[1] 刘欣欣[1] LI Yangyang;FANG Jian;WANG Xiaoxue;LIU Xinxin(Department of Geriatric Neurology,the First Affiliated Hospital of Henan University,Kaifeng 475001,Henan,China;Ward II of Department of Neurology,the First Affiliated Hospital of Henan University,Kaifeng 475001,Henan,China)

机构地区：[1]河南大学第一附属医院老年神经内科,河南开封475001 [2]河南大学第一附属医院神经内科二病区,河南开封475001

出　　处：《右江医学》2025年第1期20-26,共7页Chinese Youjiang Medical Journal

基　　金：河南省高等学校重点科研项目计划(18B310013)。

摘　　要：目的探讨老年高血压合并脑白质病变(WML)患者病情严重程度与血清水通道蛋白1(AQP1)、衰老关键蛋白抗原-5(Fibulin-5)的关系。方法回顾性选取2020年3月至2023年12月期间确诊的212例老年高血压合并WML患者作为研究对象。根据颅脑磁共振成像(MRI)检查结果,将患者分为轻度组与重度组。收集患者入组时的血清炎症指标,包括C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和IL-8,并通过酶联免疫吸附试验(ELISA)法检测血清AQP1和Fibulin-5水平。通过多元回归分析,探讨老年高血压合并WML患者血清AQP1、Fibulin-5表达水平与年龄、血清炎症指标之间的关系。通过多因素logistic回归分析,筛选出影响老年高血压合并WML患者病情严重程度的因素。利用受试者工作特征曲线(ROC曲线)分析血清AQP1、Fibulin-5表达水平对老年高血压合并WML患者病情严重程度的诊断价值。结果与轻度老年高血压合并WML患者相比,重度组患者的血清AQP1和Fibulin-5表达水平显著降低,同时年龄、CRP、TNF-α、IL-6和IL-8水平显著升高(P<0.05)。进一步分析表明,年龄、CRP、TNF-α、IL-6、IL-8对老年高血压合并WML患者的血清AQP1和Fibulin-5表达水平均具有显著的负向调节作用(P<0.05)。AQP1和Fibulin-5被视为老年高血压合并WML患者病情进展至重度的保护性因素(P<0.05)。通过ROC曲线分析,血清AQP1和Fibulin-5单独及联合检测在诊断老年高血压合并WML患者病情严重程度方面的曲线下面积(AUC)分别为0.842、0.863,联合检测的AUC为0.928,联合检测的诊断效能显著优于单独检测(P<0.05)。结论老年高血压合并脑白质病变重度患者中血清AQP1、Fibulin-5表达降低,二者联合检测对于评估疾病严重程度有重要作用。Objective To explore relationship between the severity of disease with serum aquaporin 1(AQP1)and Fibulin-5 in elderly patients with hypertension combined with cerebral white matter lesions(WML).Methods 212 elderly hypertension patients with WML diagnosed between March 2020 and December 2023 were retrospectively selected as study subjects.Based on the results of cranial magnetic resonance imaging(MRI)examination,patients were divided into mild group and severe group.Serum inflammatory markers from patients at the time of enrollment,including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-8,were collected,and serum AQP1 and Fibulin-5 levels were detected by enzyme-linked immunosorbent assay(ELISA).Relationship between serum AQP1 and Fibulin-5 expression levels,age,and serum inflammatory markers in elderly hypertensive patients with WML was explored through multiple regression analysis.Factors that affected the severity of elderly hypertension patients with WML were selected through multivariate logistic regression analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum AQP1 and Fibulin-5 expression levels for the severity of elderly hypertension patients with WML.Results The expression levels of serum AQP1 and Fibulin-5 in elderly hypertension patients with WML in the severe group were obviously lower than those in the mild group,and the levels of age,CRP,TNF-α,IL-6,and IL-8 were higher than those in the mild group(P<0.05).Further analysis showed that,age,CRP,TNF-α,IL-6,IL-8 had significant negative regulatory effects on the expression levels of serum AQP1 and Fibulin-5 in elderly hypertension patients with WML(P<0.05).AQP1 and Fibulin-5 were considered protective factors for the progression of elderly hypertension patients with WML(P<0.05).Through ROC curve analysis,the area under the curve(AUC)of serum AQP1 and Fibulin-5 detection alone and in combination for diagnosing the severity of elderly hypertension patients with WML wer

关 键 词：老年人 高血压 脑白质病变 病情程度 水通道蛋白1 衰老关键蛋白抗原-5 

分 类 号：R743.34[医药卫生—神经病学与精神病学]