不同年龄阶段血管性痴呆患者脑脊液中炎症因子检测及其临床意义

The Detection of Inflammatory Factors in Cerebrospinal Fluid of Patients with Vascular Dementia at Different Age Groups and Its Clinical Significance

目的分析不同年龄阶段血管性痴呆(vascular dementia, VD)患者脑脊液中炎症因子水平及其临床意义,探讨其发病规律。方法选取40例VD患者,按年龄分为老年组(≥65岁)和非老年组(<65岁),以及20例健康志愿者作为对照组。分别检测三组受试者脑脊液中炎症因子白介素-1β(interleukin-1β, IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)。同时对三组受试者进行细微精神状态检查(minor mental state examination, MMSE)量表测试评分以及蒙特利尔认知量表(Montreal cognitive scale, MoCA)评分。最后统计不同年龄VD患者分别与炎症因子水平、MMSE以及MoCA评分的相关性关系;炎症因子与MMSE以及MoCA评分的相关性关系。结果与对照组相比,不同年龄组VD患者的IL-1β和TNF-α水平明显升高,且老年组升高更明显(P<0.05)。不同年龄组VD患者的MMSE和MoCA评分明显低于对照组,且老年组评分降低更明显(P<0.001)。相关性分析结果显示VD患者年龄与炎症水平呈正相关(P<0.05),且与MMSE、MoCA评分呈负相关(P<0.05),炎症因子与MMSE以及MoCA评分的呈负相关(P<0.05)。结论不同年龄阶段VD患者脑脊液中炎症因子呈现升高趋势,随着年龄的增加,VD炎症因子水平越高,认知功能越低。

Objective To analyze the inflammatory factors in cerebrospinal fluid(CSF) of patients with vascular dementia(VD) at different ages and its clinical significance, and to further explore the pathogenesis of VD.Methods 40 VD patients were divided into the elderly group(>65 years old) and the non-elderly group(<65 years old), while 20 healthy volunteers were selected as the control group. Interleukin-1β(IL-1β) and Tumor necrosis factor-α(TNF-α) were detected in cerebrospinal fluid of all three groups. At the same time, all subjects in three groups were scored by Minor Mental State Examination(MMSE) scale and Montreal Cognitive Scale(MoCA). Lastly, the correlations between the levels of inflammatory factors, MMSE and MoCA scores, as well as the correlations between inflammatory factors and MMSE and MoCA scores were analyzed in VD patients of different ages.Results Compared with the control group, the levels of IL-1 beta and TNF-in VD patients of different age groups were significantly higher, and the increase was more obvious in the elderly group(P<0.001). The scores of MMSE and MoCA in VD patients of different age groups were significantly lower than those in the control group, and the scores in the elderly group were significantly lower than those in the control group(P<0.001). The correlation analysis showed that the age of VD patients was positively correlated with the level of inflammation, while negatively correlated with the scores of MMSE and MoCA. Inflammatory factors were negatively correlated with the scores of MMSE and MoCA.Conclusion Inflammatory factors in cerebrospinal fluid of VD patients at different age stages show an increasing trend. With the increase of age, the higher the level of inflammatory factors, the lower the cognitive function.