高敏C反应蛋白及免疫T细胞与认知障碍的相关性  

Associations of high-sensitivity C-reactive protein and T cells with cognitive impairment

作　　者：杨咸之 张舒 顾雪轩 魏明清[1] 李婷[1] 倪敬年[1] 时晶[1] 田金洲[1] Yang Xianzhi;Zhang Shu;Gu Xuexuan;Wei Mingqing;Li Ting;Ni Jingnian;Shi Jing;Tian Jinzhou(Third Section of Encephalopathy Department,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100007,China)

机构地区：[1]北京中医药大学东直门医院脑病科三区,100007

出　　处：《中华老年心脑血管病杂志》2025年第4期408-411,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(82074362);北京中医药大学解码中医项目(BZY-JMZY-2022-002);中国工程院战略研究与咨询项目(2022-XY-33)。

摘　　要：目的分析免疫细胞CD8~+T细胞、CD4~+T细胞及高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)与认知功能的关系,探讨免疫、慢性炎症与阿尔茨海默病相关认知障碍的关系。方法采用观察性研究设计中的横断面研究,选取2024年6~12月在北京中医药大学东直门医院阿尔茨海默病门诊就诊的101例患者,均主诉记忆力下降。采用简易智能状态检查量表(mini-mental state examination,MMSE)和延迟故事回忆量表(delayed story recall task,DSR)进行认知评估,分为观察组(伴认知障碍)60例和对照组(不伴认知障碍)41例,比较2组外周血CD8~+T细胞、CD4~+T细胞和hs-CRP水平。结果观察组MMSE评分及各子项目、DSR评分显著低于对照组,日常生活活动能力量表评分显著高于对照组,差异有统计学意义(P<0.05,P<0.01)。观察组外周血hs-CRP水平显著高于对照组(P<0.05)。二元logistic回归分析显示,CD8~+T细胞和体质量指数是认知障碍的保护因素(OR=0.998,95%CI:0.996~1.000,P=0.038;OR=0.843,95%CI:0.719~0.990,P=0.037),外周血hs-CRP水平是认知障碍的独立危险因素(OR=2.004,95%CI:1.215~3.306,P=0.006)。Spearman秩相关分析显示,hs-CRP水平与CD4~+T细胞呈显著正相关(P=0.011),与CD8~+T细胞无相关性(P>0.05)。结论慢性炎症与免疫失衡协同驱动认知衰退,hs-CRP可作为基层认知障碍筛查指标。Objective To investigate the associations of immune cells,CD8~+and CD4~+T cells,and high-sensitivity C-reactive protein(hs-CRP)with cognitive function,and to explore the relationships among immunity,chronic inflammation,and Alzheimer's disease-related cognitive impairment.Methods A cross-sectional study was conducted on 101 patients with primary complaints of memory decline who visited the Alzheimer's Disease Clinic of Dongzhimen Hospital from June to December 2024.Mini-Mental State Examination(MMSE)and Delayed Story Recall Task(DSR)were performed to assess their cognitive function,and according to the results,they were divided into observation group(cognitively impaired,60 cases)and control group(cognitively normal,41 cases).Peripheral blood levels of CD8~+T cells,CD4~+T cells,and hs-CRP were compared between the two groups.Results The observation group exhibited significantly lower total scores and scores of different dimensions of MMSE and DSR scores,but notably higher activities of daily living scores than the control group(P<0.05,P<0.01).Serum hs-CRP level was obviously elevated in the observation group than the control group(P<0.05).Binary logistic regression analysis revealed that CD8~+T cells(OR=0.998,95%CI:0.996-1.000,P=0.038)and body mass index(OR=0.843,95%CI:0.719-0.990,P=0.037)were protective factors,while hs-CRP(OR=2.004,95%CI:1.215-3.306,P=0.006)was an independent risk factor for cognitive impairment.Spearman's rank correlation analysis showed a significant positive correlation between hs-CRP and CD4~+T cells(P=0.011),but no significant association with CD8~+T cells(P>0.05).Conclusion Chronic inflammation and immune dysregulation synergistically contribute to cognitive decline.Hs-CRP may serve as a potential screening biomarker for cognitive impairment in primary care settings.

关 键 词：认知障碍 CD8阳性T淋巴细胞 C反应蛋白质 

分 类 号：R74[医药卫生—神经病学与精神病学]