摘要
目的探讨血清25-羟维生素-D3、可溶性晚期糖基化终末产物受体(sRAGE)、核苷酸结合寡聚化结构域样受体3(NLRP3)mRNA与高血压脑出血(HICH)发生认知功能损害的关系。方法选取广东医科大学附属医院收治的143例HICH患者作为研究对象, 患者治疗后发生认知功能受损的患者68例(认知障碍组)、未发生认知功能障碍的患者75例(对照组);统计比较两组患者的年龄、性别、脑出血量、出血部位、血压、血糖、血脂等一般资料, 并检测两组的25-羟维生素-D3、sRAGE、NLRP3 mRNA水平, 采用多因素logistic回归分析法分析影响HICH患者发生认知功能障碍的危险因素。结果认知功能障碍组和对照组的年龄、性别、吸烟、文化程度、出血部位、糖尿病占比率、TG、TC、LDL-C、HDL-C差异均无统计学意义(P>0.05);认知功能障碍组和对照组的出血量、NIHSS评分差异具有统计学意义(P<0.05);认知功能障碍组的25-羟维生素-D3水平低于对照组(P<0.05), NLRP3 mRNA表达水平高于对照组(P<0.05), 两组患者的sRAGE差异无统计学意义(P>0.05);经logistic回归分析, 25-羟维生素-D3水平降低、出血量增大、NIHSS评分增高是HICH患者并发认知功能障碍的独立危险因素(P<0.05)。结论血清25-羟维生素-D3水平降低可能会增加HICH患者并发认知功能障碍的风险。
Objective To investigate the relationship between serum 25 hydroxyvitamin-D3,soluble advanced glycation end product receptor(sRAGE),nucleotide binding oligomerization domain like receptor 3(NLRP3)mRNA and cognitive impairment in hypertensive intracerebral hemorrhage(HICH).Methods 143 patients with HICH treated in the Affiliated Hospital of Guangdong Medical University from July 2016 to July 2019 were selected as the research objects.Among the 143 patients with HICH,there were 68 patients with cognitive impairment(cognitive impairment group)and 75 patients without cognitive impairment(control group).The age,gender,amount of intracerebral hemorrhage,bleeding site,blood pressure,blood glucose and blood lipid of the two groups were counted,and the mRNA levels of 25 hydroxyvitamin-D3,sRAGE and NLRP3 were detected.Multivariate logistic regression analysis was used to analyze the risk factors of cognitive impairment in patients with HICH.Results There were no significant differences in age,gender,smoking,education,bleeding site,diabetes rate,triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C)between cognitive dysfunction group and control group(P>0.05);There were significant differences in bleeding volume and neurological function defect score(NIHSS)score between cognitive impairment group and control group(P<0.05);The level of 25 hydroxyvitamin-D3 in cognitive impairment group was lower than that in control group(P<0.05),and the expression level of NLRP3 mRNA was higher than that in control group(P<0.05).There was no significant difference in sRAGE between the two groups(P>0.05);Logistic regression analysis showed that the decrease of 25-hydroxyvitamin-D3 level,the increase of bleeding volume and NIHSS score were independent risk factors for cognitive impairment in HICH patients(P<0.05).Conclusions Decreased serum 25 hydroxyvitamin-D3 levels may increase the risk of cognitive impairment in patients with HICH.
作者
吴金波
杨春兰
姚振兴
郑凯文
钟博智
林文佳
Wu Jinbo;Yang Chunlan;Yao Zhenxing;Zheng Kaiwen;Zhong Bozhi;Lin Wenjia(Department of Emergency,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)
出处
《中国医师杂志》
CAS
2021年第10期1492-1495,1500,共5页
Journal of Chinese Physician
