血管性痴呆患者血清可溶性凋亡因子的变化及与认知障碍的关系

Changes of serum soluble apoptosis factors and their relations with cognition disorders in the patients with vascular dementia

目的探讨血管性痴呆（VaD）患者血清可溶性凋亡相关因子（sFas）和其配体（sFasL）的水平变化及与患者认知障碍的相关性。方法采用双抗夹心酶联免疫吸附法（ELIsA）检测70例VaD患者[平均年龄（72．5±7．5）岁]血清sFas和sFasL水平，并与50例健康老年人[平均年龄（70．6±3．7）岁]比较；使用日常生活能力量表（ADL）、简易精神状态量表（MMSE）、缺血指数量表（Hachinski）评定患者认知功能。结果VaD患者外周血清sFas和sFasL分别为（228．0±60．7）μg／L和（146．8±30．1）μg／L，健康老年人分别为（62．4±22．6）μg／L和（82．3±18．7）μg／L，VaD患者高于健康老年人（t=-20．883，14．453，均P〈0．01）。血管性痴呆患者血清sFas与患者年龄、ADL和Hachinski呈负相关，与MMSE呈正相关（r=-0．956，-0．943，-0．950和0．904，均P〈0．01）；血清sFasL与MMSE呈负相关，与年龄、ADL和Hachinski呈正相关（r=-0．899，0．963，0．948和0．939，均P〈0．01）。结论VaD患者发病过程中可能存在神经细胞凋亡，并且外周血清sFas和sFasL浓度可能与患者认知水平相关。

Objective To investigate the changes of serum soluble factor-related apoptosis （sFas） and soluble Fas ligand （sFasL） and their relations with cognition disorders in the patients with vascular dementia （VaD）. Methods Serum concentrations of sFas and sFasl were detected by enzyme-linked immunosorbent assay （ELISA） and compared between 70 patients with VaD aged （72.5±7.5）years and 50 healthy elderly people aged（72.5±7.5）years. The VaD patient＇s cognitive functions were evaluated by activity of daily living scale （ADL）, mini-mental state examination （MMSE） and hachinski ischemia score （Haehinski）. Results The serum levels of sFas and sFasL in VaD patients were （228.0±60.7）μg/L and （146.8±30.1）μg/L, and in the healthy elderly were （62.4±22.6）μg/L and （82.3± 18. 7）μg/L, respectively. The serum levels of apoptosis factors in VaD patients were significantly higher than in the healthy controls （t= 20. 883,14. 453, P〈0.01）. sFas level was negatively correlated with age, the scores of ADL and Hachinski while positively with the scores of MMSE （r=-0.956,--0.943,--0.950 and 0.904,all P〈0.01）. sFasL level was negatively correlated with the scores of MMSE while positively with age, the scores of ADL and Hachinski （r=-0.899,0.963,0.948 and 0.939,all P〈0.01）. Conclusions Apoptosis may be involved in the pathological change during VaD and the serum levels of sFas and sFasL might be related with cognition disorders.