摘要
目的探讨外周血低分子量肽酶2(LMP2)、消退素D1(RVD1)水平与急性缺血性脑卒中(AIS)患者认知障碍(CI)的相关性。方法选取2021年1月—2024年7月青海省人民医院急诊内科收治的AIS患者216例为AIS组,同期健康体检志愿者65例为健康对照组,随访6个月根据是否发生CI将AIS患者分为CI亚组72例和非CI亚组144例。采用酶联免疫吸附法检测外周血LMP2、RVD1水平;Pearson相关系数分析AIS患者外周血LMP2、RVD1水平与简易精神状态检查(MMSE)评分和蒙特利尔认知评估量表(MoCA)评分的相关性;多因素Logistic回归分析AIS患者发生CI的影响因素;受试者工作特征(ROC)曲线分析外周血LMP2、RVD1水平对AIS患者发生CI的预测效能。结果与健康对照组比较,AIS组外周血LMP2水平升高,RVD1水平降低(t/P=13.957/<0.001、28.146/<0.001);AIS患者外周血LMP2水平与MMSE、MoCA评分呈负相关(r/P=-0.718/<0.001、-0.704/<0.001),RVD1水平与MMSE、MoCA评分呈正相关(r/P=0.707/<0.001、0.726/<0.001);与非CI亚组比较,CI亚组外周血LMP2水平升高,RVD1水平降低(t/P=10.361/<0.001、-9.762/<0.001);多因素Logistic回归分析显示,年龄大、NIHSS评分高、梗死体积大、LMP2高为AIS患者发生CI的独立危险因素[OR(95%CI)=1.072(1.007~1.142)、1.500(1.271~1.771)、1.580(1.286~1.941)、1.006(1.003~1.008)],RVD1高为独立保护因素[OR(95%CI)=0.738(0.648~0.840)];外周血LMP2、RVD1水平及二者联合预测AIS患者发生CI的曲线下面积(AUC)分别为0.792、0.804、0.895,二者联合的AUC大于外周血LMP2、RVD1水平单独预测(Z/P=3.920/<0.001、3.764/<0.001)。结论外周血LMP2水平升高、RVD1水平降低与AIS患者CI有关,二者联合预测AIS患者CI的效能较高。
Objective To explore the correlation between peripheral low molecular mass peptide 2(LMP2),resolvin D1(RVD1),and cognitive impairment(CI)in acute ischemic stroke(AIS)patients.Methods From January 2021 to July 2024,216 AIS patients and 65 healthy controls were enrolled.Followed for 6 months,AIS patients were divided into CI(n=72)and non-CI(n=144)subgroups.LMP2 and RVD1 levels were measured by ELISA.Pearson correlation analyzed their relationships with MMSE and MoCA scores.Multivariate Logistic regression identified CI risk factors,and ROC curves evaluated predictive value.Results AIS patients had higher LMP2 and lower RVD1 than controls(t/P=13.957/<0.001,28.146/<0.001).LMP2 negatively correlated with MMSE/MoCA(r/P=-0.718/<0.001,-0.704/<0.001),while RVD1 showed positive correlations(r/P=0.707/<0.001,0.726/<0.001).CI subgroup had higher LMP2 and lower RVD1(t/P=10.361/<0.001,-9.762/<0.001).Age,NIHSS score,infarct volume,and high LMP2 were independent risk factors for CI[OR=1.072(1.007-1.142),1.500(1.271-1.771),1.580(1.286-1.941),1.006(1.003-1.008)],while high RVD1 was protective[OR=0.738(0.648-0.840)].The AUCs for LMP2,RVD1,and their combination were 0.792,0.804,and 0.895,with the combination being superior(Z/P=3.920/<0.001,3.764/<0.001).Conclusion Elevated LMP2 and reduced RVD1 are linked to CI in AIS.Combined measurement enhances predictive efficacy.
作者
王楠
孙嘉林
张蕊蕊
吉国栋
刘洁
Wang Nan;Sun Jialin;Zhang Ruirui;Ji Guodong;Liu Jie(Emergency Internal Medicine,Qinghai Provincial People’s Hospital,Qinghai,Xining 810007,China;不详)
出处
《疑难病杂志》
2025年第8期900-905,共6页
Chinese Journal of Difficult and Complicated Cases
基金
青海省科技计划项目(2023-ZJ-789)。
作者简介
通信作者:刘洁,E-mail:13997299966@163.com。
