脑小血管病患者病程进展与血管内皮功能障碍因子表达水平的相关性研究

A study on the correlation between disease progression and expression levels of endothelial dysfunction-related factors in patients with cerebral small vessel disease

目的探讨脑小血管病(CSVD)患者病程进展与血管内皮功能障碍(ED)因子[同型半胱氨酸(Hcy)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和C反应蛋白(CRP)]表达水平的相关性.方法选取2016年6月至2017年9月在我科诊断为CSVD的患者60例作为研究对象,所有患者均进行了头颅MRI检查.采集外周血,利用ELISA检测与血管内皮功能障碍相关因子Hcy、TNF-α、IL-6和CRP的表达水平.对所纳入患者进行1年时间的随访,随访期内均进行头颅MRI检查.根据随访观察结果,将所纳入患者分为进展组和无进展组,比较两组患者血清Hcy、TNF-α、IL-6和CRP表达水平的差异,并分析它们与CSVD进展的相关性.结果在60例患者中,病程进展的有38例,病程无进展的有22例.与病程无进展组相比,病程进展组患者血清Hcy(17.62+7.23 VS 11.35±5.41,P=0.007)和IL-6(17.46±6.97 VS8.48士4.67,P=0.001)的表达水平高;TNF-α和CRP的表达水平在两组间无差异.经Spearman等级相关分析发现,CSVD患者的病程进展与血清Hcy(r=0.587,P=0.015)和IL-6(r=0.644,P=0.009)的表达水平存在相关性;而与TNF-α和CRP的表达水平不存在相关性.结论CSVD患者血清中血管内皮功能障碍因子Hcy、IL-6的表达水平与病程进展存在相关性,检测这些因子的表达对于判断病情预后具有一定参考意义.

Objective To investigate the correlation between disease progression and expression levels of endothelial dysfunction(ED)-related factors(homocysteine[Hcy],tumor necrosis factor-alpha[TNF-α],interleukin-6[IL-6],and C-reactive protein[CRP])in patients with cerebral small vessel disease(CSVD).Methods A total of 60 patients who were diagnosed with CSVD in our department from June 2016 to September 2017 were enrolled as study subjects.All the patients underwent a cerebral MRI examination.The peripheral blood samples of the patients were collected and tested for expression levels of ED-related factors(Hcy,TNF-α,IL-6,and CRP)using ELISA.All the patients enrolled were followed up for 1 year,during which cerebral MRI examinations were regularly performed.According to the follow-up results,the patients were divided into progression group and progression-free group.The two groups were compared for differences in the expression levels of serum Hcy,TNF-α,IL-6,and CRP.Meanwhile,the correlation between these indices and CSVD progression was analyzed.Results Among the 60 patients,38 had disease progression,and 22 had no disease progression.Compared with the progression-free group,the progression group had significantly higher levels of Hcy(11.35±5.41 vs 17.62±7.23,P=0.007)and IL-6(8.48±4.67 vs 17.46±6.97,P=0.001),but there were no significant differences in the expression levels of TNF-αand CRP between the two groups.A Spearman rank correlation analysis revealed that disease progression was correlated with the expression levels of Hcy(r=0.587,P=0.015)and IL-6(r=0.644,P=0.009)but not correlated with the expression levels of TNF-αand CRP in patients with CSVD.Conclusions The expression levels of ED-related factors in serum such as Hcy and IL-6 are correlated with disease progression in patients with CSVD.Therefore,measuring the expression of these factors can provide a reference for the prognosis of the disease.