慢性脑低灌注性血管性认知损害患者血清p75神经营养素受体细胞外段水平及其与炎性因子的关系

Serum p75 neurotrophin receptor-extracellular domain level and its relationship with inflammatory factors in patients with chronic cerebral hypoperfusion-vascular cognitive impairment

目的检测慢性脑低灌注性血管性认知损害(CCH-VCI)患者血清p75神经营养素受体细胞外段(p75NTR-ECD)水平,并探讨其与肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-6的关系。方法选择海军军医大学(第二军医大学)长海医院2018年8月至12月收治的34例CCH-VCI患者,以及同期相同年龄段的36名中老年健康人和34例缺血性脑卒中患者作为研究对象。采用酶联免疫吸附试验测定3组研究对象的血清p75NTR-ECD、TNF-α、IL-1β、IL-6水平并进行组间比较。采用Spearman相关分析研究CCH-VCI患者血清p75NTR-ECD水平与TNF-α、IL-1β、IL-6水平的相关性。结果CCH-VCI组血清p75NTR-ECD水平高于健康对照组和缺血性脑卒中组[(544.36(440.88,628.50)pg/mL vs 276.49(262.59,313.87)pg/mL、366.87(337.09,450.43)pg/mL],差异均有统计学意义(U=87.500、335.500,P均<0.05)。CCH-VCI组患者血清TNF-α、IL-1β、IL-6水平分别为196.02(141.20,280.35)pg/mL、68.23(60.79,91.94)pg/mL、51.04(40.24,65.26)pg/mL,缺血性脑卒中组分别为218.67(143.76,281.28)pg/mL、76.87(59.10,99.91)pg/mL、64.45(43.13,86.76)pg/mL,均分别高于健康对照组[分别为73.71(56.94,79.81)pg/mL、42.98(34.52,51.34)pg/mL、14.97(11.76,21.19)pg/mL],差异均有统计学意义(U=31.000、4.000,106.000、132.000,48.000、13.000;P均<0.05)。CCH-VCI患者血清p75NTR-ECD水平与TNF-α水平存在相关性(r=0.391,P=0.022),但与IL-1β和IL-6水平均无明显相关性(r=0.032、0.164,P=0.855、0.355)。结论慢性脑低灌注损伤后p75NTR可能与TNF-α等炎性因子有关,并共同参与了CCH-VCI的发病。

Objective To investigate serum p75 neurotrophin receptor-extracellular domain(p75NTR-ECD)level in patients with chronic cerebral hypoperfusion-vascular cognitive impairment(CCH-VCI)and its relationship with tumor necrosis factorα(TNF-α),interleukin(IL)-1βand IL-6.Methods The clinical data of patients with CCH-VCI(n=34)were collected from Changhai Hospital,Naval Medical University(Second Military Medical University)from Aug.to Dec.2018.Enzyme linked immunosorbent assay was applied for detection of serum levels of p75NTR-ECD,TNF-α,IL-1βand IL-6;and the results were then compared with those of ischemic stroke participants(n=34)and healthy controls(n=36),who were all in the same age range.Spearman correlation analysis was used to analyze the relationship between serum p75NTR-ECD level and the above-mentioned inflammatory factors in CCH-VCI patients.Results The serum p75NTR-ECD level in the CCHVCI group was significantly higher than those in the healthy control group and the ischemic stroke group(544.36[440.88,628.50]pg/mL vs 276.49[262.59,313.87]pg/mL and 366.87[337.09,450.43]pg/mL,U=87.500 and 335.500,both P<0.05).The serum levels of TNF-α,IL-1βand IL-6 were 196.02(141.20,280.35)pg/mL,68.23(60.79,91.94)pg/mL and 51.04(40.24,65.26)pg/mL in the CCH-VCI group,respectively,and 218.67(143.76,281.28)pg/mL,76.87(59.10,99.91)pg/mL and 64.45(43.13,86.76)pg/mL in the ischemic stroke group,respectively,which were all significantly higher than those in the healthy control group(73.71[56.94,79.81]pg/mL,42.98[34.52,51.34]pg/mL and 14.97[11.76,21.19]pg/mL,respectively;U=31.000 and 4.000,106.000 and 132.000,and 48.000 and 13.000;all P<0.05).Serum p75NTR-ECD level in the CCH-VCI patients was correlated with TNF-αlevel(r=0.391,P=0.022),but not with IL-1βor IL-6 levels(r=0.032 and 0.164,P=0.855 and 0.355).Conclusion Serum p75NTR level may be related to inflammatory factors(TNF-α)after chronic cerebral hypoperfusion,and they may jointly participate in the pathogenesis of CCH-VCI.