非痴呆型脑小血管病患者血清Hcy TGF-β1及BDNF表达与认知功能障碍的关系

Relationship between the expressions of Hcy,TGF-β1,BDNF and cognitive dysfunction in patients with non-dementia type cerebrovascular disease

目的探讨非痴呆型脑小血管病(cerebral small vessel disease,CSVD)患者血清同型半胱氨酸(homocysteine,Hcy)、转化生长因子-β1(transformed growth factor-1,TGF-β1)及脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)表达与认知功能障碍的关系。方法选取117例CSVD患者为研究对象,根据是否存在认知功能障碍(vascular cognitive impairment of none dementia,VCIND)分为VCIND组(41例)和CSVD组(76例)。检测2组血清Hcy、TGF-β1、BDNF水平,分析VCIND组血液指标水平与蒙特利尔认知评估(MoCA)评分的相关性。结果VCIND组患者血清Hcy水平较CSVD组升高,血清TGF-β1、BDNF水平较CSVD组降低(P<0.05)。Logistic回归分析显示,Hcy为VCIND的危险因素(B=0.334,OR=1.396,P=0.000),而TGF-β1、BDNF为VCIND的保护因素(B=-0.066,OR=0.937,P=0.005;B=-0.751,OR=0.472,P=0.004)。血清Hcy水平与MoCA评分呈负相关,血清TGF-β1、BDNF表达与MoCA评分呈正相关性(P<0.05)。结论Hcy、TGF-β1及BDNF表达与VCIND的发生有关,其血清水平能够反映患者认知功能障碍程度。

Objective To investigate the relationship between the expression of homocysteine(Hcy),transforming growth factor-β1(TGF-β1),brain-derived neurotrophic factor(BDNF)and cognitive dysfunction in patients with cerebral small vessel disease(CSVD).Methods 117 patients with CSVD were selected as study subjects.Those patients were divided into the VCIND group(41 cases)and the CSVD group(76 cases)according to the presence of vascular cognitive impairment of none dementia(VCIND).Serum levels of Hcy,TGF-β1 and BDNF in the two groups were detected.The correlation between three indexes and Montreal cognitive assessment(MoCA)score was analyzed in the VCIND group.Results Serum Hcy level in VCIND group was higher than that in CSVD group,and serum TGF-β1 and BDNF levels were lower than that in CSVD group(P<0.05).Logistic regression analysis showed that Hcy was a risk factor for VCIND(B=0.334,OR=1.396,P=0.000),while TGF-β1 and BDNF were protective factors for VCIND(B=-0.066,OR=0.937,P=0.005;B=-0.751,OR=0.472,P=0.004).The serum Hcy level was negatively correlated with MoCA score,and the expression of TGF-β1 and BDNF was positively correlated with MoCA score(P<0.05).Conclusion The expressions of Hcy,TGF-β1 and BDNF are related to the occurrence of VCIND,and their serum levels can reflect the degree of cognitive impairment in patients with VCIND.