进展性脑梗死后抑郁患者血清炎症因子表达水平及其与脑白质疏松和认知功能损害的关系  

Expression level of serum inflammatory factors in patients with depression after progressive cerebral infarction and its relationship with leukoaraiosis and cognitive impairment

作　　者：冉倩 范崇桂[1] 马伟锋 宋彦[1] RAN Qian;FAN Chonggui;MA Weifeng;SONG Yan(Department of Neurology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院神经内科,473000

出　　处：《中国健康心理学杂志》2025年第4期524-529,共6页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20191467)。

摘　　要：目的:探讨进展性脑梗死后抑郁患者血清炎症因子表达水平及其与脑白质疏松和认知功能损害的关系。方法:选取某院收治的60例进展性脑梗死后抑郁患者,依据脑白质疏松严重程度(Fazekas量表)将患者分为轻度组(12例)、中度组(28例)和重度组(20例);依据认知功能损害[蒙特利尔认知评估量表(MoCA)或简易精神状态检查量表(MMSE)]分为认知损害组与非认知损害组,各30例,比较轻度组、中度组与重度组,认知损害组、非认知损害组一般资料、血清炎症因子[中性粒细胞/淋巴细胞比值(NLR)、超敏C反应蛋白(hs-CRP)、高迁移率族蛋白B1(HMGB1)、单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP-9)]水平,影响因素用Logistic法,相关性用Spearman法。结果:重度组患者血清NLR、hs-CRP、HMGB1、MCP-1、MMP-9水平较轻、中度组高,中度组上述因子水平较轻度组高(F=32.455,10.684,10.229,20.042,10.050;P<0.05);认知损害组血清NLR、hs-CRP、HMGB1、MCP-1、MMP-9水平较非认知障碍组高(t=5.774,8.329,6.538,7.195,8.295;P<0.05);经Logistic回归和Pearson相关性分析显示,血清NLR、hs-CRP、HMGB1、MCP-1、MMP-9水平是进展性脑梗死后抑郁患者发生脑白质疏松、认知功能损害的影响因素,且脑白质疏松、认知功能损害均呈正相关(OR=3.549,3.153,3.469,3.647,3.885,3.695,3.212,3.634,4.159,3.687;r=0.484,0.525,0.475,0.533,0.516,0.491,0.509,0.486,0.548,0.527;P<0.05)。结论:血清炎性因子(NLR、hs-CRP、HMGB1、MCP-1、MMP-9)水平不仅反映进展性脑梗死后抑郁患者脑白质疏松和认知功能损害程度,还是其相关影响因素。Objective:To investigate the expression level of serum inflammatory factors in patients with depression after progressive cerebral infarction and its relationship with leukoaraiosis and cognitive impairment.Methods:A total of 60 patients with depression after progressive cerebral infarction were selected and divided into mild group(12 cases),moderate group(28 cases)and severe group(20 cases)according to the severity of leukoaraiosis(Fazekas scale).According to the cognitive impairment[Montreal Cognitive Assessment Scale(MoCA)or Mini Mental State Examination Scale(MMSE)],they were divided into cognitive impairment group and non-cognitive impairment group,with 30 cases in each group.Compare the general data and serum inflammatory factor[Neutrophil/lymphocyte ratio(NLR),high sensitivity C-reactive protein(hs-CRP),high mobility group protein B1(HMGB1),monocyte chemoattractant protein-1(MCP-1)and matrix metalloproteinase-9(MMP-9)]levels of mild group,moderate group and severe group,cognitive impairment group and non-cognitive impairment group.Logistic method was used for influencing factors and Spearman method for correlation.Results:Serum WBC,NEU,hs-CRP,IL-6 and TNF-αlevels in severe group were higher than those in moderate group and mild group,and the above factors in moderate group were higher than those in mild group(F=32.455,10.684,10.229,20.042,10.050;P<0.05).The levels of serum NLR,hs-CRP,HMGB1,MCP-1 and MMP-9 in cognitive impairment group were higher than those in non-cognitive impairment group(t=5.774,8.329,6.538,7.195,8.295;P<0.05).Logistic regression and Pearson correlation analysis showed that the levels of serum NLR,hs-CRP,HMGB1,MCP-1 and MMP-9 were the influencing factors of leukoaraiosis and cognitive impairment in patients with depression after progressive cerebral infarction,and the leukoaraiosis and cognitive impairment were positively correlated(O r=3.549,3.153,3.469,3.647,3.885,3.695,3.212,3.634,4.159,3.687,r=0.484,0.525,0.475,0.533,0.516,0.491,0.509,0.486,0.548,0.527,P<0.05).Conclusion:Serum infl

关 键 词：进展性脑梗死 抑郁 炎症因子 脑白质疏松 认知功能损害 

分 类 号：R395.2[哲学宗教—心理学] R749.4[医药卫生—医学心理学]