脑小血管病轻度认知损害与血清炎性因子的相关性

ASSOCIATION BETWEEN MILD COGNITIVE IMPAIRMENT AND SERUM INFLAMMATORY FACTORS IN CEREBRAL SMALL VESSEL DISEASE

目的探讨脑小血管病(CSVD)轻度认知损害与血清炎性因子相关性。方法CSVD病人100例,其中CSVD不伴认知障碍者和CSVD伴有认知障碍者各50例,同时选取健康体检者50例为健康对照组。采用蒙特利尔认知评估(MoCA)量表及日常生活活动能力(ADL)量表评定CSVD病人认知功能,检测各组受检者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平。应用Pearson相关系数分析血清炎症因子Hcy、hs-CRP、IL-6和TNF-α水平与CSVD认知功能障碍间的相关性。结果CSVD伴认知障碍组视空间与执行功能、命名、记忆、注意力、语言、抽象能力、定向评分低于健康对照组及CSVD不伴认知障碍组,差异有显著性(F=6.782~10.663,P<0.05);健康对照组、CSVD不伴认知障碍组各项目评分比较,差异无统计学意义(P>0.05)。CSVD伴认知障碍组炎性因子Hcy、hs-CRP、IL-1、TNF-α水平均明显高于健康对照组和CSVD不伴认知障碍组,差异有显著性(F=14.119~20.173,P<0.05);CSVD伴认知障碍组血清Hcy、hs-CRP、IL-1、TNF-α水平与MoCA视空间与执行功能、命名、记忆、注意力、语言、抽象能力、定向评分均有相关性(r=-2.432^-0.039,P<0.05)。结论血清学指标Hcy、hs-CRP、IL-1、TNF-α检测联合MoCA量表和ADL量表评估可以提高CSVD伴有认知功能障碍的诊断效率。

Objective To investigate the association between mild cognitive impairment and serum inflammatory factors in patients with cerebral small vessel disease (CSVD). Methods A total of 100 patients with CSVD were enrolled, among whom 50 had no cognitive impairment and 50 had cognitive impairment, and 50 healthy individuals were enrolled as healthy control group. Montreal Cognitive Assessment (MoCA) and Activity of Daily Life Scale (ADL) were used to evaluate cognitive function in CSVD patients, and the serum levels of homocysteine (Hcy), positive high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α) were measured. The Pearson correlation coefficient was used to analyze the correlation of the serum inflammatory factors Hcy, hs-CRP, IL-6, and TNF-α with cognitive impairment in CSVD. Results Compared with the healthy control group and the non-cognitive impairment CSVD group, the cognitive impairment+CSVD group had significantly lower scores of visual space and executive function, naming, memory, attention, language, abstract ability, and orientation ( F =6.782-10.663, P <0.05);there were no significant differences in the scores of each item between the healthy control group and the non-cognitive impairment CSVD group ( P >0.05). The cognitive impairment+CSVD group had significantly higher levels of the inflammatory factors Hcy, hs-CRP, IL-6, and TNF-α than the healthy control group and the non-cognitive impairment CSVD group ( F =14.119-20.173, P <0.05). In the cognitive impairment+CSVD group, serum levels of Hcy, hs-CRP, IL-6, and TNF-α were correlated with the scores of visual space and executive function, naming, memory, attention, language, abstraction ability, and orientation in MoCA ( r =-2.432 to -0.039, P <0.05). Conclusion The serological markers Hcy, hs-CRP, IL-6, and TNF-α combined with MoCA and ADL scales can improve the diagnostic efficiency for CSVD with cognitive impairment.