缺血性卒中患者血清NSE、BDNF水平变化与认知功能的相关性

Correlation between Cognitive Function and Serum Levels of Neuron Specific Enolase and Brain-derived Neurotrophic Factor in Patients with Ischemic Stroke

目的:评估缺血性卒中后认知障碍程度与外周血神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)含量的关系。方法:218例急性脑卒中患者依据简明精神状态量表(MMSE)评分分为认知障碍组144例(轻度亚组68例,中度亚组44例及重度亚组32例)及非认知障碍组74例。于治疗前、治疗后1、3月时评估患者的日常活动能力(ADL)评分,检测血清NSE、BDNF水平。结果:治疗前及治疗后1、3月认知障碍组的NSE水平高于非认知障碍组(P<0.05)。治疗前认知障碍组的BDNF水平低于非认知障碍组(P<0.05);治疗1月时2组差异仍有统计学意义(P<0.05),3月时2组差异无统计学意义(P>0.05)。治疗前及治疗后1、3月认知障碍组的ADL评分低于非认知障碍组(P<0.05)。认知障碍组血清NSE和MMSE评分呈负相关(r2=0.635,P<0.05),血清BDNF和MMSE评分呈正相关(r2=0.335,P<0.05)。结论:缺血性卒中患者的NSE、BDNF水平与认知功能损伤的严重程度密切相关。

Objective： To explore the correlation of cognitive impairment induced by ischemic stroke and se- rum neuron specific enolase （NSE）, brain-derived neurotrophic factor （BDNF）. Methods： Total 218 patients with ischemic stroke were divided into groups of cognitive impairment （n=144, 68 cases in mild subgroup, 44 cases in moderate subgroup and 32 cases in severe subgroup） and none cognitive impairment （n=74） according to MMSE scores. The activity of daily living （ADL） scores and serum NSE, BDNF were examined before and 1, 3 months after treatment. Results： The NSE levels of cognitive impairment group were significantly higher than those in the none cognitive impairment group before and 1, 3 months after treatment （P〈0.05）. The BDNF level of cognitive impairment group was lower than that in the none cognitive impairment group （P〈0.05） before the treatment. The BDNF levels between the two groups was different 1 month after treatment （P〈0.05） but showed no difference 3 months after treatment （P〉0.05）. The ADL scores of cognitive impairment group were signifi- cantly higher than those in the none cognitive impairment group before and 1, 3 months after treatment （P〈0.05）. The NSE level in serum was negatively correlated with MMSE scores in patients with cognitive impairment（r2= 0.635, P〈0.05）, and the BDNF in serum positively correlated with MMSE scores in patients with cognitive im- pairment （r2=0.335, P〈0.05）. Conclusion： The NSE and BDNF levels of patients with ischemic stroke were closely related to the severity of cognitive fimction.