摘要
目的探究细胞因子和血管内皮功能指标在脑梗死患者中的表达及与认知水平的关系。方法选取2022年1月至2024年7月景德镇市中医医院收治的86例脑梗死患者作为研究对象,根据病情严重程度分为轻度组(n=41)、中度组(n=28)与重度组(n=17);另选取同期61例健康体检者作为对照组。比较4组炎症因子[超敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)、白细胞介素(interleukin,IL)-6、IL-17及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、血管内皮功能[一氧化氮(nitric oxide,NO)、内皮素1(endothelin 1,ET-1)、氧化低密度脂蛋白(oxidized low-density lipoprotein,Ox-LDL)、内皮细胞依赖性血管舒张功能(flow-mediated dilation,FMD)、内皮细胞非依赖性血管舒张功能(endothelial-independent vasodilation,EID)]、认知水平[蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易精神状态检查(mini mental status examination,MMSE)评分];采用Pearson相关分析细胞因子及血管内皮功能指标与认知水平的相关性。结果对照组、轻度组、中度组、重度组血清hs-CRP、IL-6、IL-17与TNF-α水平比较差异有统计学意义,且后一组高于前一组,差异均有统计学意义(P<0.05)。对照组、轻度组、中度组、重度组NO、FMD水平比较差异有统计学意义,且后一组低于前一组,差异均有统计学意义(P<0.05);对照组、轻度组、中度组、重度组ET-1、Ox-LDL水平比较差异有统计学意义,且后一组高于前一组,差异均有统计学意义(P<0.05);4组EID比较差异无统计学意义。对照组、轻度组、中度组、重度组MoCA、MMSE评分比较差异有统计学意义,且后一组低于前一组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,hs-CRP、IL-6、IL-17、TNF-α、ET-1、Ox-LDL与MoCA、MMSE评分均呈负相关(r<0,P<0.05);NO、FMD与MoCA、MMSE评分均呈正相关(r>0,P<0.05);EID与MoCA、MMSE评分均无相关性。结论脑梗死患者的细胞因子水平和血管内皮功能指标与其认知水平关系密切,可客观反映患者的认知水平,有助于临床尽早采取相应的干预对策,减轻患者认知功能损伤,提高其认知水平。
Objective To explore the expression of cytokines and vascular endothelial function indices in patients with cerebral infarction and its relationship with cognitive level.Methods A total of 86 patients with cerebral infarction admitted to Jingdezhen Hospital of Traditional Chinese Medicine from January 2022 to July 2024 were selected as the research subjects,they were divided into the mild group(n=41),moderate group(n=28)and the severe group(n=17)according to the severity of the disease;another 61 healthy subjects in the same period were selected as the control group.The inflammatory factors(high-sensitivity C reactive protein[hs-CRP],interleukin[IL]-6,IL-17 and tumor necrosis factor-α[TNF-α]),vascular endothelial function(nitric oxide[NO],endothelin 1[ET-1],oxidized low-density lipoprotein[Ox-LDL],flow-mediated dilation[FMD],endothelial-independent vasodilation[EID]),cognitive level(Montreal cognitive assessment[MoCA],mini mental status examination[MMSE]score)were compared among the four groups;Pearson correlation analysis was used to analyze the expression of cytokines and vascular endothelial function indices correlation with cognitive level.Results There were significant differences in the levels of serum hs-CRP,IL-6,IL-17 and TNF-α among the control group,mild group,moderate group and the severe group,and the latter group was higher than the former group,the differences were statistically significant(P<0.05).There were significant differences in the levels of NO and FMD among the control group,mild group,moderate group and the severe group and the latter group was lower than the former group,the differences were statistically significant(P<0.05).There were significant differences were observed in the levels of ET-1 and Ox-LDL among the four groups,and the latter group was higher than the former group,the differences were statistically significant(P<0.05);there were No significant difference in EID among the four groups.There were significant differences in the MoCA and MMSE scores among the control group,mild group,moderate group and the severe group,and the latter group was lower than the former group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that hs-CRP,IL-6,IL-17,TNF-α,ET-1 and Ox-LDL were negatively correlated with MoCA and MMSE scores(r<0,P<0.05);NO and FMD were positively correlated with MoCA and MMSE scores(r>0,P<0.05);there was no correlation between EID and MoCA,MMSE scores.Conclusion The levels of cytokines and vascular endothelial function indices in patients with cerebral infarction are closely related to their cognitive level,which is helpful to take corresponding intervention measures as soon as possible to reduce the cognitive impairment of patients and improve their cognitive level.
作者
顾贞锋
叶佑亮
史高宽
江丽娅
GU Zhenfeng;YE Youliang;SHI Gaokuan;JIANG Liya(Department of Laboratory Medicine,Jingdezhen Hospital of Traditional Chinese Medicine,Jingdezhen,Jiangxi,333000,China)
出处
《当代医学》
2025年第14期99-103,共5页
Contemporary Medicine
基金
江西省景德镇市科技计划项目(20232SFZC043)。
关键词
细胞因子
血管内皮功能
脑梗死
认知水平
Cytokines
Vascular endothelial function
Cerebral infarction
Cognitive level
