摘要
目的:探讨血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)与急性缺血性卒中患者卒中后认知损害(post-stroke cognitive impairment,PSCI)的相关性,并评估其对PSCI的预测价值。方法:前瞻性纳入2018年4月至2020年9月济宁医学院附属医院收治的急性缺血性卒中患者。在发病后3个月时采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评估认知损害。采用多变量logistic分析确定血清BDNF与PSCI的独立相关性,并采用受试者工作特征(receiver operating characteristics,ROC)曲线评估其对PSCI的预测价值。结果:共纳入511例急性缺血性卒中患者,男性332例(65.0%),年龄(60.67±10.18)岁(范围49~80岁);基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分中位数5.0分(2.7~6.7分),前循环卒中413例(80.8%);血清BDNF中位数11.54μg/L(6.13~16.25μg/L)。310例(60.7%)发生PSCI。单变量分析显示,PSCI组年龄、既往短暂性脑缺血发作史、基线NIHSS评分和血清BDNF与非PSCI组差异存在统计学意义(P均<0.05)。多变量logistic分析显示,血清BDNF与PSCI存在显著独立相关性(优势比0.514,95%置信区间0.356~0.807;P=0.005)。ROC曲线分析显示,血清BDNF预测PSCI的曲线下面积为0.863(95%置信区间0.830~0.896;P<0.001),最佳截断值为10.78μg/L,敏感性和特异性分别为74.9%和86.8%。结论:基线血清BDNF较高是PSCI的保护因素,对PSCI具有良好的预测价值。
Objective:To investigate the correlation between serum brain-derived neurotrophic factor(BDNF)and post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke,and to evaluate its predictive value for PSCI.Methods:Patients with acute ischemic stroke admitted to the Affiliated Hospital of Jining Medical University from April 2018 to September 2020 were prospectively enrolled.Cognitive impairment was assessed by Montreal Cognitive Assessment(MoCA)at 3 months after onset.Multivariate logistic analysis was used to determine the independent correlation between serum BDNF and PSCI,and receiver operating characteristics(ROC)curve was used to evaluate its predictive value for PSCI.Results:A total of 511 patients with acute ischemic stroke were enrolled,including 332 males(65.0%),aged 60.67±10.18(range 49-80)years.The median score of the National Institutes of Health Stroke Scale(NIHSS)at the baseline was 5.0(interquartile range 2.7-6.7),and 413 patients(80.8%)had anterior circulation stroke.The median of serum BDNF was 11.54μg/L(interquartile range 6.13-16.25μg/L).PSCI occurred in 310 patients(60.7%).Univariate analysis showed that there were significant differences in age,history of previous transient ischemic attack,baseline NIHSS score and serum BDNF between the PSCI group and the non-PSCI group(all P<0.05).Multivariate logistic analysis showed that there was a significant independent correlation between serum BDNF and PSCI(odds ratio 0.514,95%confidence interval 0.356-0.807;P=0.005).ROC curve analysis showed that the area under the curve of serum BDNF predicting PSCI was 0.863(95%confidence interval 0.830-0.896;P<0.001).The best cut-off value was 10.78μg/L,and the sensitivity and specificity were 74.9%and 86.8%respectively.Conclusion:Higher baseline serum BDNF was a protective factor for PSCI and had good predictive value for PSCI.
作者
张婧
张魁
巩利
朱云亮
马倩倩
Zhang Jing;Zhang Kui;Gong Li;Zhu Yunliang;Ma Qianqian(Department of Neurology(Ⅲ),the Affiliated Hospital of Jining Medical University,Jining 272000,China)
出处
《国际脑血管病杂志》
2022年第2期99-103,共5页
International Journal of Cerebrovascular Diseases
关键词
卒中
脑缺血
脑源性神经营养因子
认知障碍
危险因素
生物标志物
Stroke
Brain ischemia
Brain-derived neurotrophic factor
Cognition disorders
Risk factors
Biomarkers
