摘要
目的探讨血清丙二醛(MDA)、超氧化物歧化酶(SOD)、白细胞介素-1β(IL-1β)、干扰素-γ(IFN-γ在血管性痴呆(VD)中的表达及其与神经功能和预后的关联性。方法选取2017年1月至2019年1月中国兵器工业521医院98例VD患者作为研究组,另选同期98例健康体检者为对照组。检测并比较两组受检者的血清MDA、SOD、IL-1β、IFN-γ水平,并对比研究组不同神经功能缺损程度、不同预后患者的上述血清指标水平,分析上述血清指标水平与VD患者神经功能、预后的相关性及其对VD发病的影响因素,采用受试者工作特征曲线(ROC)估血清MDA、SOD、IL-1β、IFN-γ水平对VD患者预后的预测价值。结果研究组患者的血清MDA、IL-1β、IFN-γ水平分别为(6.59±0.71) nmol/mL、(67.90±9.08) pg/mL、(194.64±14.31) pg/mL,明显高于对照组的(4.06±0.42) nmol/mL、(45.21±7.14) pg/mL、(131.59±9.75) pg/mL;血清SOD水平为(86.27±10.95) U/mL水平,明显低于对照组的(129.73±18.51) U/mL,差异均有统计学意义(P<0.05);经Logistic回归分析发现,血清MDA、SOD、IL-1β、IFN-γ均为VD发病的重要影响因素(P<0.05);不同神经功能缺损程度、不同预后VD患者的血清MDA、SOD、IL-1β、IFN-γ水平比较差异均有统计学意义(P<0.05);血清MDA、IL-1β、IFN-γ水平与VD患者神经功能、预后呈负相关(P<0.05),血清SOD水平与VD患者神经功能、预后呈正相关(P<0.05);经ROC分析可知,血清MDA、SOD、IL-1β、IFN-γ水平评估VD患者预后为Ⅲ级的AUC分别为0.855、0.690、0.843、0.672,其中血清MDA的AUC最高,当血清MDA>7.50 nmol/mL时,其评估VD患者预后为Ⅲ级的敏感度为90.00%,特异度为81.82%。结论 VD患者血清MDA、IL-1β、IFN-γ、SOD水平均呈异常表达状态,与VD患者神经功能、预后具有密切关系,且均为VD发病的影响因素,动态监测上述血清指标水平可为临床评估VD患者病情程度及预后提供重要数据参考。
Objective To investigate the expression of serum malondialdehyde(MDA), superoxide dismutase(SOD), interleukin-1β(IL-1β), interferon-γ(IFN-γ) in vascular dementia(VD) and its correlation with neurological function and prognosis. Methods From January 2017 to January 2019, 98 patients with VD in 521 Hospital of China North Industries Group Corporation Limited were selected as the study group, and 98 healthy people who underwent physical examination during the same period were selected as the control group. The serum MDA, SOD, IL-1β, IFN-γlevels of the two groups were detected and compared, and the levels of the above serum indicators of patients with different degrees of neurological deficits and different prognosis in the study group were compared. The correlation between the above serum indexes and the neurological function and prognosis of patients with VD and their influencing factors on the incidence of VD were analyzed. The receiver operating characteristic curve(ROC) was used to evaluate the predictive value of serum MDA, SOD, IL-1β, IFN-γ levels on the prognosis of patients with VD. Results The serum MDA, IL-1β, and IFN-γ levels of patients in the study group were(6.59±0.71) nmol/m L,(67.90±9.08) pg/m L, and(194.64±14.31) pg/m L, which were significantly higher than(4.06±0.42) nmol/m L,(45.21±7.14) pg/m L,(131.59±9.75) pg/m L of the control group. The serum SOD level was(86.27±10.95) U/m L, which was significantly lower than(129.73±18.51) U/m L of the control group(P<0.05). Logistic regression analysis found that serum MDA, SOD, IL-1β, and IFN-γ were all important influencing factors of VD(P<0.05). Comparison of serum levels of MDA, SOD, IL-1β, and IFN-γ in patients with different neurological deficits and different prognosis of VD showed statistically significant differences(P<0.05). Serum MDA, IL-1β, IFN-γ levels were negatively correlated with neurological function and prognosis in VD patients(P<0.05), and serum SOD levels were positively correlated with neurological function and prognosis in VD patients(P<0.05). According to ROC analysis, the AUC of patients with VD evaluated by serum MDA, SOD, IL-1 β and IFN-γ was0.855, 0.690, 0.843, and 0.672, respectively, among which, the AUC of serum MDA was the highest. When the serum MDA was more than 7.50 nmol/mL, the sensitivity for assessing the prognosis of VD patients as grade Ⅲ was 90.00%,and the specificity was 81.82%. Conclusion The levels of serum MDA, IL-1β, IFN-γ, and SOD in VD patients are abnormally expressed, which are closely related to the neurological function and prognosis of VD patients. Dynamic monitoring of the above-mentioned serum index levels can provide important data references for clinical assessment of the disease status and prognosis of VD patients.
作者
李建瑞
马冉冉
樊新红
袁博博
LI Jian-rui;MA Ran-ran;FAN Xin-hong;YUAN Bo-bo(Department of Neurology,521 Hospital of Ordnance Industries Group Corporation Limited,Xi'an 710065,Shaanxi,CHINA;Department of Neurology,Xi'an Ninth Hospital,Xi'an 710054,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第4期433-437,共5页
Hainan Medical Journal
