摘要
目的观察血管性认知功能障碍(VCI)患者血清可溶性CD40配体(sCD40L)、同型半胱氨酸(Hcy)和内皮素1(ET-1)的临床意义。方法选取2011年6月至2012年8月在我院连续住院的脑梗死患者279例,依据脑卒中后6个月的认知评定结果分为血管性痴呆(VD)组75例,血管性非痴呆认知障碍(VCIND)组123例和认知正常组(对照组)81例。观察各组血清sCD40L,ET-1、Hcy水平和简易精神状态评价量表(MMSE)评分的变化,及其与VCI严重程度的关系。结果 VD组和VCIND组的MMSE评分比对照组明显降低(P<0.01);sCD40L,ET-1和Hcy水平较对照组明显增高(P<0.01),MMSE评分(19.58±2.67)分、(25.94±1.68)分vs(28.46±1.56)分,sCD40L(7.45±2.24)μg/L、(5.98±1.94)μg/L vs(3.46±0.76)μg/L,ET-1(88.35±3.64)ng/L、(81.65±4.35)ng/L vs(65.24±5.64)ng/L,Hcy(25.67±4.25)mmol/L、(18.54±3.24)mmol/L vs(10.25±2.68)mmol/L;而VD组的增高水平较VCIND组更为明显(P<0.01)。MMSE评分、sCD40L、ET-1和Hcy水平随着VCI严重程度的增高而增高(P<0.05或<0.01)。结论 sCD40L,ET-1和Hcy参与了VCI疾病的发生、发展过程,血浆sCD40L、ET-1和Hcy水平与VCI严重程度呈正相关,可以作为VCI疾病严重程度的重要指标。
Objective To observe the clinical significance of soluble CD40 ligand(sCD40L),homocysteine(Hcy),endothelin-1(ET-1)in patients with vascular cognitive impairment(VCI).Methods A total of 279 patients with cerebral infarction who got treatment in the hospital from June 2011 to August 2012,were divided into three groups:vascular dementia(VD)group(75cases),vascular cognitive impairment no dementa(VCIND)group(123cases)and cognitively normal group(control group,81cases)according to the scores of cognitive assessment after 6months′stroke.The levels of serum sCD40L,ET-1,Hcy and MMSE score were observed in all groups and their relation to the severity of VCI was evaluated.Results MMSE score in VD group and VCIND group was significantly lower,(19.58±2.67)marks,(25.94±1.68)marks vs(28.46±1.56)marks(P 0.01),but sCD40L,ET-1 and Hcy levels were significantly higher in VD group and VCIND group compared with those of control group(P 0.01),(7.45±2.24)μg/L,(5.98±1.94)μg/L vs(3.46±0.76)μg/L;(88.35±3.64)ng/L,(81.65±4.35)ng/L vs(65.24±5.64)ng/L;(25.67±4.25)mmol/L,(18.54±3.24)mmol/L vs(10.25±2.68)mmol/L,while the increasing levels of VD group were more obvious significantly compared with VCIND group(P 0.01).The levels of MMSE score,sCD40L,ET-1and Hcy increased as the severity of VCI increased(P 0.05or0.01).Conclusion The sCD40L,ET-1and Hcy were involved in the occurrence and development of VCI,there are positive correlation among sCD40L,ET-1,Hcy and severity of VCI,they can be used as important indicators of the severity in VCI.
出处
《临床荟萃》
CAS
2013年第10期1098-1100,1103,共4页
Clinical Focus