Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor ...Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.展开更多
目的:探究与分析血清成纤维细胞生长因子(Fibroblast growth factor23,FGF-23)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、正常T细胞表达和分泌的活性调节蛋白(the regulated uPon activation normal T cell exPressed and s...目的:探究与分析血清成纤维细胞生长因子(Fibroblast growth factor23,FGF-23)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、正常T细胞表达和分泌的活性调节蛋白(the regulated uPon activation normal T cell exPressed and secreted,RANTES)在慢性肾脏病患者中的表达水平及临床意义。方法:选取我院自2018年7月~2021年7月收治的116例慢性肾脏病患者作为观察组,另选择同时期在我院肾脏科实施常规检查的健康成年人100例作为对照组,将观察组患者按照不同的疾病分期分为1期组(n=27)、2期组(n=26)、3期组(n=22)、4期组(n=20)、5期组(n=21),1期组的肾小球滤过率(eGFR)≥90Uml/(min·1.73m^(2)),2期的eGFR在60至899ml/(min·1.73m^(2))之间,3期的eGFR在30至599ml/(min·1.73m^(2))之间,4期的eGFR在15至299ml/(min·1.73m^(2))之间,5期的eGFR≤14/(min·1.73m^(2)),对比观察组与对照组血清FGF-23、TNF-α、RANTES水平以及血清CysC、SCr及eGFR水平;对比观察组5个不同分期下患者血清FGF-23、TNF-α、RANTES水平,同时监测观察组不同分期下患者血清CysC、SCr水平,分析FGF-23、TNF-α、RANTES与CysC、SCr及eGFR的相关性。结果:观察组与对照组相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,差异有统计学意义(P<0.05)。2期、3期、4期、5期分别与1期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,3期、4期、5期分别与2期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,4期及5期分别与3期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,5期与4期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,差异有统计学意义(P<0.05)。行SPearman分析可见,FGF-23、TNF-α、RANTES分别与CysC、SCr呈正相关性,与eGFR呈负相关性(P<0.05)。结论:血清FGF-23、TNF-α、RANTES的升高可作为判断慢性肾脏病疾病进展的可靠指标,随着疾病的进展,血清FGF-23、TNF-α、RANTES开始呈现出升高的趋势,且与患者的肾功能指标密切相关。在今后的研究中可进一步的扩大研究样本量分析,同时增加观察指标,以此更好的探讨慢性肾脏病的发病机制。展开更多
基金supported by the National Natural Science Foundation of China,No.81673263(to YHZ)Ministry of Science and Technology of China,No.2016YFC1307300(to YHZ)a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(to YHZ)
文摘Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.
文摘目的:探究与分析血清成纤维细胞生长因子(Fibroblast growth factor23,FGF-23)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、正常T细胞表达和分泌的活性调节蛋白(the regulated uPon activation normal T cell exPressed and secreted,RANTES)在慢性肾脏病患者中的表达水平及临床意义。方法:选取我院自2018年7月~2021年7月收治的116例慢性肾脏病患者作为观察组,另选择同时期在我院肾脏科实施常规检查的健康成年人100例作为对照组,将观察组患者按照不同的疾病分期分为1期组(n=27)、2期组(n=26)、3期组(n=22)、4期组(n=20)、5期组(n=21),1期组的肾小球滤过率(eGFR)≥90Uml/(min·1.73m^(2)),2期的eGFR在60至899ml/(min·1.73m^(2))之间,3期的eGFR在30至599ml/(min·1.73m^(2))之间,4期的eGFR在15至299ml/(min·1.73m^(2))之间,5期的eGFR≤14/(min·1.73m^(2)),对比观察组与对照组血清FGF-23、TNF-α、RANTES水平以及血清CysC、SCr及eGFR水平;对比观察组5个不同分期下患者血清FGF-23、TNF-α、RANTES水平,同时监测观察组不同分期下患者血清CysC、SCr水平,分析FGF-23、TNF-α、RANTES与CysC、SCr及eGFR的相关性。结果:观察组与对照组相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,差异有统计学意义(P<0.05)。2期、3期、4期、5期分别与1期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,3期、4期、5期分别与2期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,4期及5期分别与3期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,5期与4期相比血清FGF-23水平较高、TNF-α水平较高、RANTES水平较高、CysC水平较高、SCr水平较高、eGFR水平较低,差异有统计学意义(P<0.05)。行SPearman分析可见,FGF-23、TNF-α、RANTES分别与CysC、SCr呈正相关性,与eGFR呈负相关性(P<0.05)。结论:血清FGF-23、TNF-α、RANTES的升高可作为判断慢性肾脏病疾病进展的可靠指标,随着疾病的进展,血清FGF-23、TNF-α、RANTES开始呈现出升高的趋势,且与患者的肾功能指标密切相关。在今后的研究中可进一步的扩大研究样本量分析,同时增加观察指标,以此更好的探讨慢性肾脏病的发病机制。
