脑梗死患者高半胱氨酸与类胰岛素样生长因子-1的表达水平及与认知功能的相关性分析

Analysis of expression levels and correlation with cognitive function of hypercystine and insulin-like growth factor-1 in patients with cerebral infarction

目的探讨脑梗死患者高半胱氨酸(t Hcy)与类胰岛素样生长因子-1(IGF-1)的表达水平及与认知功能的相关性。方法我院收治的93例脑梗死患者(脑梗死组)及同期46例健康体检者(非脑梗死组),比较两组t Hcy、IGF-1表达水平,根据脑梗死患者认知功能分为认知功能障碍组与认知功能正常组,比较两组t Hcy、IGF-1表达水平,分析影响脑梗死患者产生认知功能障碍相关危险因素。结果脑梗死组t Hcy浓度高于非脑梗死组,IGF-1浓度及MoCA评分均低于非脑梗死组(P <0. 05)。52例(55. 91%)出现认知功能障碍,41例(44. 08%)认知功能正常。年龄>60岁、t Hcy≥15. 4μmol/L、IGF-1 <140. 3ng/ml、SBP≥140 mm Hg、DBP≥90 mm Hg是影响脑梗死患者发生认知功能障碍的独立危险因素(P <0. 05)。结论血清IGF-1与t Hcy浓度是影响脑梗死患者发生认知功能障碍的独立危险因素,IGF-1 <140. 3 ng/ml或t Hcy≥15. 4μmol/L者发生脑梗死患者发生认知功能障碍的风险较大。

Objective To analyze the expression levels of homocysteine(tHcy)and insulin-like growth factor 1(IGF-1)in patients with cerebral infarction and their correlation with cognitive function.Methods The clinical data of 93 patients with cerebral infarction and 46 healthy patients who were treated in our hospital were retrospectively analyzed.The patients were divided into cerebral infarction and non-cerebral infarction group.The expression levels of tHcy and IGF-1 were compared between the two groups.Based on cognitive function,the patients were divided into cognitive dysfunction group and normal cognitive group.The expression levels of tHcy and IGF-1 level were compared the two groups.The influence factors related to cognitive dysfunction in the patients were analyzed.Results The tHcy concentrations of the cerebral infarction group was significantly higher than that of the non-cerebral infarction group,and the IGF-1 concentration and MoCA score were significantly lower than that of the non-cerebral infarction group(P<0.05).There were 52 patients(55.91%)developing cognitive dysfunction and 41(44.08%)patients with normal cognitive function.The results of multiple logistic regression analysis showed that age>60,tHcy greater than or equal to 15.4 pmol/L,IGF-1 less than 140.3 ng/ml,SBP greater than or equal to 140 mmHg,and DBP greater than or equal to 90 mmHg were independent risk factors for cognitive dysfunction in the patients with cerebral infarction(P<0.05).Conclusion Serum IGF-1 and tHcy concentrations are independent risk factors for cognitive dysfunction in patients with cerebral infarction.Patients with cerebral infarction whose IGF-1<140.3 ng/ml or tHcy>15.4μmol/L have a higher risk of cognitive dysfunction.