皮质下血管性认知功能障碍患者血清sCD40L水平的变化

Clinical significance of soluble CD40 ligand in patients with subcortical ischemic cognitive impairment

目的探讨皮质下缺血性脑血管病(SIVD)认知障碍患者血清中可溶性CD40配体(sCD40L)的水平及其与认知障碍、白质病变(WML)的相关性。方法对SIVD中19例血管性痴呆(VD)患者2、0例血管性无痴呆型认知损害(VCIND)患者及15例年龄及性别相当的健康老年人行认知功能测试,采用酶联免疫吸附法(ELISA)检测受试者血清sCD40L水平;同时行头颅MRI扫描,应用年龄相关白质改变分级方法,对WML评分,进一步分析sCD40L与认知功能、WML的关系。结果①SIVD两组与正常对照组相比,血清sCD40L浓度增高(P<0.05),两组之间差异不显著(P>0.05)。②SIVD患者sCD40L水平与MMSE、MoCA、WML评分均无明显相关性(P>0.05)。结论①皮质下血管性认知障碍患者血清sCD40L水平较正常老年人均明显升高s,CD40L可能参与SIVD发生、发展;②血清sCD40L水平与认知功能损害、白质病变程度无明显相关。

Objective To evaluate the level of soluble CD40 ligand（sCD40L） in the serum of patients with subcortical ischemic vascular disease（SIVD）and the correlation with cognition and white matter lesions（WML）.Methods 19 patients with VD,20 patients with VCIND and 15 gender and age matched normal controls（NC） were recruited.All subjects were underwent neuropsychological assessment and conventional MRI.The serum level of sCD40L was detected by enzyme linked immunosorbent assay（ELISA） in all subjects.In addition,the relationship was described among sCD40L,WML and cognitive impairment in patients with SIVD.Results（1） A statistically increase of sCD40L serum level of SIVD patients versus healthy controls was detected（P〈0.05）.No significant difference between VD and VCIND groups was observed（P〈0.05）.（2） There was no statistically correlation between the serum level of sCD40L and MMSE,MoCA,WML scores（P〈0.05）.Conclusions（1） Increased serum level of sCD40L in patients with SIVD might indicate that inflammatory processes may be activated in SIVD.（2） Enhanced serum level of sCD40L could not imply the association with the severity of cognitive impairment and WML in SIVD patients.