血清可溶性细胞间黏附分子-1、基质金属蛋白酶-9、脂联素水平与脑梗死患者血管性认知障碍的相关性研究  

Correlation study of serum soluble intercellular adhesion molecule-1,matrix metalloproteinase-9 and adiponectin levels with vascular cognitive impairment in patients with cerebral infarction

作　　者：赵超 陈志伟 郑剑钧 李霞 ZHAO Chao;CHEN Zhiwei;ZHENG Jianjun;LI Xia(Department of Neurology,Shangrao Municipal Hospital,Jiangxi Province,Shangrao334000,China)

机构地区：[1]江西省上饶市立医院神经内科,江西上饶334000

出　　处：《中国当代医药》2025年第10期46-49,54,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410981)。

摘　　要：目的探讨血清可溶性细胞间黏附分子-1(sICAM-1)、基质金属蛋白酶-9(MMP-9)、脂联素水平与脑梗死患者血管性认知障碍(VCI)的相关性。方法回顾性分析2023年7月至2024年8月在上饶市立医院就诊的90例脑梗死患者的病历资料,根据是否发生VCI分为VCI组和非VCI组。检测血清sICAM-1、MMP-9、脂联素水平,采用描述性统计、单因素和多因素logistic回归分析、相关性分析、ROC曲线分析确定血清sICAM-1、MMP-9和脂联素水平与脑梗死后VCI之间的相关性,并计算ROC曲线参数。结果VCI组患者血清sICAM-1、MMP-9水平高于非VCI组,脂联素水平低于非VCI组,差异有统计学意义(P<0.05);多因素分析结果显示,卒中次数(β=0.619,OR=1.857,95%CI:0.965~4.683)、血清sICAM-1(β=0.658,OR=1.931,95%CI:1.209~3.085)、血清MMP-9(β=0.625,OR=1.868,95%CI:1.160~3.008)、脂联素(β=-0.894,OR=0.409,95%CI:0.222~0.752)是脑梗死患者发生VCI的独立影响因素(P<0.05)。相关性分析显示,血清sICAM-1、MMP-9水平与脑梗死患者VCI严重程度呈正相关(r=0.518、0.479,P<0.05),脂联素水平与脑梗死患者VCI严重程度呈负相关(r=-0.447,P<0.05)。ROC曲线分析显示,脂联素的AUC为0.818,血清MMP-9的AUC为0.793,血清sICAM-1的AUC为0.781。结论血清sICAM-1、MMP-9、脂联素水平与脑梗死患者发生VCI的风险紧密相关,对预测脑梗死后VCI具有较高的价值。Objective To explore the correlation between serum soluble intercellular adhesion molecule-1(sICAM-1),matrix metalloproteinase-9(MMP-9)and adiponectin levels and vascular cognitive impairment(VCI)in patients with cerebral infarction.Methods The medical records of 90 patients with cerebral infarction in Shangrao Municipal Hospital were retrospectively analyzed from July 2023 to August 2024.According to whether VCI occurred,the patients were divided into VCI group and non-VCI group.The levels of serum sICAM-1,MMP-9 and adiponectin were detected.Descriptive statistics,univariate and multivariate logistic regression analyses,correlation analysis and receiver operating characteristic curve(ROC)analysis were used to determine the correlation between serum sICAM-1,MMP-9 and adiponectin and VCI after cerebral infarction,and ROC curve parameters were calculated.Results Serum sICAM-1 and MMP-9 in VCI group were higher than those in non-VCI group,while the level of adiponectin was lower than that in non-VCI group,the differences were statistically significant(P<0.05).Multivariate analysis showed that stroke frequency(β=0.619,OR=1.857,95%CI:0.965-4.683),serum sICAM-1(β=0.658,OR=1.931,95%CI:1.209-3.085),serum MMP-9(β=0.625,OR=1.868,95%CI:1.160-3.008)and adiponectin(β=-0.894,OR=0.409,95%CI:0.222-0.752)were independent influencing factors for VCI in patients with cerebral infarction(P<0.05).Correlation analysis showed that serum sICAM-1 and MMP-9 levels were positively correlated with the severity of VCI(r=0.518,0.479,P<0.05),and adiponectin level was negatively correlated with the severity of VCI in patients with cerebral infarction(r=-0.447,P<0.05).ROC curve analysis showed that the AUC of adiponectin was 0.818,the AUC of serum MMP-9 was 0.793 and the AUC of serum sICAM-1 was 0.781.Conclusion Serum sICAM-1,MMP-9 and adiponectin are closely related to the risk of VCI in patients with cerebral infarction,and have high value on predicting VCI after cerebral infarction.

关 键 词：脑梗死 血管性认知障碍 可溶性细胞间黏附分子-1 基质金属蛋白酶-9 脂联素 相关性 

分 类 号：R741[医药卫生—神经病学与精神病学]