VILIP-1、TSH、UACR与脑小血管病的病情进展及认知功能障碍的相关性研究  

Study on the correlation of VILIP-1,TSH,UACR with the development of cerebral small vessel disease and cognitive dysfunction

作　　者：侯春寒 夏红英 王建宇[1] HOU Chunhan;XIA Hongying;WANG Jianyu(Department of Neurology,Harrison International Peace Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]哈励逊国际和平医院神经内科,河北衡水053000

出　　处：《检验医学与临床》2025年第5期581-586,共6页Laboratory Medicine and Clinic

基　　金：国家自然科学基金项目(82302879);河北省卫生健康委员会医学科学研究项目(20211563)。

摘　　要：目的探讨视锥蛋白样蛋白-1(VILIP-1)、促甲状腺激素(TSH)、尿清蛋白/肌酐比值(UACR)与脑小血管病(CSVD)病情进展及认知功能障碍(CI)的相关性。方法选取2021年9月至2022年9月于该院就诊的144例CSVD患者作为观察组,根据白质高信号Fazekas量表评分将观察组分为轻度组、中度组和重度组;根据CSVD患者是否合并CI将观察组分为合并CI组和未合并CI组。另选取同期该院100例健康体检者作为对照组。采用酶联免疫吸附试验检测各组VILIP-1、TSH水平,采用HEX DEM检测仪检测各组尿清蛋白、肌酐水平,并计算UACR。比较观察组和对照组生物标志物水平;比较不同病情CSVD患者的临床特征;采用Spearman相关分析CSVD患者VILIP-1、TSH水平及UACR与CSVD病情进展的相关性;比较合并CI组和未合并CI组临床特征;采用多因素Logistic回归分析CSVD患者发生CI的危险因素;采用受试者工作特征(ROC)曲线分析VILIP-1、TSH、UACR对CSVD患者发生CI的预测价值。结果观察组VILIP-1、TSH水平及UACR均明显高于对照组,差异均有统计学意义(P<0.05)。轻度组、中度组和重度组年龄、合并高血压、合并糖尿病、蒙特利尔认知评估量表评分,以及VILIP-1、TSH水平及UACR比较,差异均有统计学意义(P<0.05)。合并CI组和未合并CI组年龄、发病时间、VILIP-1、TSH水平及UACR比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,CSVD患者VILIP-1、TSH水平及UACR与CSVD病情进展均呈正相关(P<0.05)。多因素Logistic回归分析结果显示,高龄、发病时间过长,以及VILIP-1、TSH水平及UACR升高均为CSVD患者发生CI的独立危险因素(P<0.05)。ROC曲线分析结果显示,VILIP-1、TSH、UACR联合检测预测CSVD患者发生CI的曲线下面积(AUC)为0.879,大于VILIP-1、TSH、UACR单独检测的AUC,差异均有统计学意义(Z=4.782、3.274、3.685,P=0.001、0.009、0.004)。结论CSVD患者VILIP-1、TSH水平及UACR与CSVD的病情进展及Objective To investigate the correlation of cone-like protein-1(VILIP-1),thyroid stimulating hormone(TSH),urinary albumin/creatinine ratio(UACR)with the development of cerebral small vessel disease(CSVD)and cognitive dysfunction(CI).Methods A total of 144 CSVD patients treated in the hospital from September 2021 to September 2022 were selected as the observation group.According to the Fazekas scale score of white matter hyperintensity,the observation group was divided into mild group,moderate group and severe group.According to the CSVD patients with CI or not,the observation group was divided into CI group and non-CI group.At the same time,100 healthy people were selected as the control group from the hospital.The levels of VILIP-1 and TSH were detected by enzyme-linked immunosorbent assay,HEX DEM was used to detect the levels of urinary albumin and creatinine in each group,and UACR was calculated.Spearman correlation analysis was used to analyze the correlation between VILIP-1,TSH levels,UACR and the CSVD progression in CSVD patients.The clinical characteristics of CSVD patients with and without CI were compared.The correlation between biomarkers and the progression of CSVD was analyzed.The clinical characteristics of CI group and the non-CI group were compared.Multivariate Logistic regression was used to analyze the risk factors of CI in CSVD patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of VILIP-1,TSH,UACR for CI in CSVD patients.Results The VILIP-1,TSH levels and UACR in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in age,hypertension,diabetes,Montreal cognitive assessment scale score,VILIP-1,TSH levels and UACR among the mild group,moderate group and severe group(P<0.05).There were significant differences in age,onset time,VILIP-1,TSH levels and UACR between the CI group and the non-CI group(P<0.05).Spearman correlation analysis show

关 键 词：脑小血管病 认知功能障碍 视锥蛋白样蛋白-1 促甲状腺激素 尿清蛋白/肌酐比值 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]