摘要
目的探讨皮质下缺血性血管病(SIVD)患者血清可溶性CD40配体(sCD40L)的表达水平及其对认知功能的影响。方法选取SIVD患者82例为SIVD组,筛选同时期健康体检者44例为对照组,依据头颅MRI表现评估入选者白质病变(WML)程度(Fazekas评分)和腔隙性脑梗死(LI)数量,ELISA法测定血清sCD40L水平,采用MoCA量表评估总体的认知功能,比较SIVD组与对照组之间一般资料、血清sCD40L水平、脑损伤程度、认知功能评分,并分析sCD40L水平与脑损伤程度、认知功能评分的相关性。结果 SIVD组血清sCD40L水平、Fazekas评分、LI数量显著高于对照组,MoCA评分显著低于对照组,差异均有统计学意义(P<0.05);相关分析显示,sCD40L水平与Fazekas评分、LI数量呈正相关(r=0.346、0.344,P<0.01),sCD40L水平与MoCA评分具有负相关性(r=-0.716,P<0.001);多元回归分析显示,总胆固醇(OR=2.427,95%CI 1.037~5.682)、sCD40L水平(OR=1.248,95%CI 1.147~1.359)均是SIVD的独立影响因素(P<0.05)。结论血清sCD40L水平升高可能是SIVD的独立危险因素,且血清sCD40L水平与SIVD严重程度、认知功能密切相关。
Objective To investigate the expression level of serum soluble CD40 ligand(sCD40 L) in patients with subcortical ischemic vascular disease(SIVD) and its effect on cognitive function.Methods 82 patients with SIVD were selected as SIVD group,and 42 healthy subjects were selected as controls.According to the MRI findings of the skull,the white matter lesions(WML) degree(Fazekas score) and lacunar infarction(LI) were evaluated.Serum sCD40 L levels were determined by ELISA.The MoCA scale was used to evaluate the overall cognitive function.The general data,serum sCD40 L level,brain injury degree,and cognitive function score were compared between SIVD group and control group.Then,the correlation between sCD40 L level and brain damage degree and cognitive function score was analyzed.Results The serum sCD40 L level,Fazekas score and LI number in the SIVD group were significantly higher than those in the control group.The MoCA score was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The correlation analysis showed that the sCD40 L level was positive with the Fazekas score(r=0.346,P<0.05) and the LI number(r=0.344,P<0.05),while sCD40 L level was negatively correlated with MoCA score(r=-0.716,P<0.001).Multiple logistic regression analysis showed total cholesterol(OR=2.427,95% CI:1.037-5.682),sCD40 L levels(OR=1.248,95% CI:1.147-1.359) were independent factors of SIVD(P<0.05).Conclusion sCD40 L is involved in the pathogenesis of SIVD,and elevated serum sCD40 L levels may be an independent risk factor for SIVD,and elevated levels of sCD40 L are closely related to the degree of SIVD lesions and cognitive impairment.
作者
宋莉莉
倪明珠
王瑶
高文平
王兆平
王文静
SONG Lili;NI Mingzhu;WANG Yao;GAO Wenping;WANG Zhaoping;WANG Wenjing(Department of Neurology,Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,China;Department of Neurology,Wuhu Second People's Hospital,Wuhu 241000,China;Department of Neurology,Second People's Hospital of Anhui Province,Hefei 230001,China;Department of Neurology,Bengbu First People's Hospital,Bengbu 233000,China)
出处
《中国实用神经疾病杂志》
2019年第22期2465-2471,共7页
Chinese Journal of Practical Nervous Diseases
基金
安徽省卫生厅医学科研课题(编号:13zc032)
