皮质下缺血性血管病患者血清炎性因子水平及其与认知功能损害的关系

Serum inflammatory factors levels and their correlation with cognitive impairment in patients with subcortical ischemic vascular disease

目的 探讨皮质下缺血性血管病(SIVD)患者血清可溶性细胞间黏附分子1(sICAM-1)、超敏C反应蛋白(hs-CRP)、胰岛素样生长因子1(IGF-1)、可溶性CD40配体(sCD40L)、白细胞介素6(IL-6)水平变化及其与认知功能损害的关系。方法 将83例SIVD患者根据认知能力分为血管性痴呆组(VaD组)41例和血管性认知障碍非痴呆组(VCIND组)42例,另取25例认知功能正常者作为对照组(NC组)。比较3组血清sICAM-1、hs-CRP、IGF-1、sCD40L、IL-6水平变化,分析SIVD患者认知功能与上述指标的相关性。结果 3组的高血压病史、教育年限、蒙特利尔认知评估量表和临床痴呆评定量表得分差异有统计学意义(P<0.05)。VaD组、VCIND组sICAM-1、sCD40L、IL-6水平高于NC组,IGF-1水平低于NC组(均P<0.05)。SIVD患者血清IGF-1与认知功能评分相关(P<0.05)。结论 SIVD患者血清sICAM-1、sCD40L、IL-6水平升高,IGF-1水平降低,其中血清IGF-1水平对患者认知功能有一定影响。

Objective To investigate the changes in serum soluble intercellular adhesion molecule 1(sICAM-1),high-sensitivity C-reactive protein(hs-CRP),insulin-like growth factor 1(IGF-1),soluble CD40 ligand(sCD40 L),interleukin 6(IL-6) levels and their correlation with cognitive impairment among patients with subcortical ischemic vascular disease(SIVD).Methods Eighty-three patients with SIVD were divided into vascular dementia group(VaD group,n=41) and vascular cognitive impairment-no dementia group(VCIND group,n=42) according to their cognitive ability,and another 25 individuals with normal cognitive function were enrolled as control group(NC group).Changes in serum sICAM-1,hs-CRP,IGF-1,sCD40 L and IL-6 levels were compared among the three groups,and the correlation of cognitive function with the indices mentioned above was analyzed in patients with SIVD.Results There were statistically significant differences among the three groups in history of hypertension,years of receiving education,and scores of the Montreal Cognitive Assessment(MoCA) Scale and the Clinical Dementia Rating(CDR) Scale(P<0.05).The VaD and VCIND groups had higher levels of sICAM-1,sCD40 L and IL-6 as well as a lower IGF-1 level than the NC group(all P<0.05).Serum IGF-1 correlated with cognitive function scores in patients with SIVD(P<0.05).Conclusion Patients with SIVD have higher serum sICAM-1,sCD40 L and IL-6 levels and a lower IGF-1 level,and serum IGF-1 level has a certain effects on patients′ cognitive function.