遗忘型轻度认知功能损害患者血清脑源性神经营养因子及血浆组织型纤溶酶原激活剂水平变化及其临床意义

Changes and its clinical significance of serum brain-derived neurotrophic factor level and plasma tissue plasminogen activator level in patients with amnestic mild cognitive impairment

目的探讨遗忘型轻度认知功能损害（aMCI）患者血清脑源性神经营养因子（BDNF）和血浆组织型纤溶酶原激活剂（t-PA）水平变化及其与aMCI发病的关系。方法应用多维度神经心理测试评估99例aMCI患者和99名正常对照者的神经认知功能;采用酶联免疫吸附法测定血清BDNF和血浆t-PA水平,并进行相关性分析。结果（1）aMCI组神经认知功能测试成绩明显低于正常对照组（均P〈0.01）,尤以反映情节记忆的听觉词语记忆测试（AVMT）的延迟回忆受损最明显。（2）aMCI组血清BDNF水平[4.37（0.02-14.54）ng/ml]明显低于正常对照组[4.82（1.06-33.12）ng/ml]（P〈0.05）,血浆t-PA水平[（6.98±3.25）ng/ml]明显高于正常对照组[（6.18±2.32）ng/ml]（P〈0.05）。（3）aMCI患者血清BDNF水平与血浆t-PA不相关;血清BDNF和血浆t-PA水平均与AVMT的延迟回忆显著相关（r=0.264,P〈0.01;r=-0.216,P〈0.05）。结论aMCI患者AVMT延迟回忆受损最明显;血清BDNF和血浆t-PA水平的变化与aMCI的认知功能损害密切相关。

Objective To investigate the changes and its clinical significance of serum brain-derived neurotrophic factor （BDNF） level and plasma tissue plasminogen activator（ t-PA ） level in patients with amnestic mild cognitive impairment （aMCI）. Methods 99 aMCI patients （aMCI group） and 99 matched normal controls （NC group） were recruited for the present study. Multi-dimension neuropsychologic tests were used to extensively assess cognitive function of subjects. An enzyme-linked immunosorbent assay was applied to measure serum BDNF level and plasma t-PA level. The correlation analysis between serum BDNF level and plasma t-PA level tested by ELISA and cognitive function were also made. Results （ 1 ） The results neuropsychologic tests in aMCI gnoup were significantly lower than those in NC group （ all P 〈 0. 01 ） , with the most impairment on delayed recall of the auditory verbal memory test （AVMT）. （2） The serum level of BDNF in aMCI group [ 4.37 （ 0.02 - 14.54） ng/ml ] was significantly lower than that in NC group [ 4.82 （ 1.06 - 33.12 ） ng/ml ] （ P 〈 0. 05 ） ; inversely, the plasma level of t- PA in aMCI group [ （ 6.98 ± 3.25 ） ng/ml ] was significantly higher than that in NC group [ （ 6. 18 ± 2.32 ） ng/ml （ P 〈 0. 05 ）. （3） The serum BDNF level was not related to the plasma t-PA level. There were significant correlations between the serum level of BDNF or the plasma level of t-PA and the score on delayed recall of AVMT （r = 0.264, P 〈 0. 01 ; r = - 0. 216, P 〈 0. 05） in aMCI group. Conclusions The damage in delaged recall of AVMT is most significant in patients with aMCI. There are colser ralations between the invasion of aMCI and the changes of serum BDNF level and plasma t-PA level.