急性脑梗死后运动障碍和神经功能恶化与H-FABP、MBP及BDNF的相关性分析

Correlation analysis of dyskinesia and neurological deterioration with H-FABP,MBP and BDNF after acute cerebral infarction

目的探讨急性脑梗死(ACI)后运动障碍和神经功能恶化与心肌型脂肪酸结合蛋白(H-FABP)、碱性髓鞘蛋白(MBP)及脑源性神经生长因子(BDNF)的相关性。方法选取2018年10月到2019年9月入本院神经内科住院ACI的患者130例作为研究组,同时选择同期体检健康的人30例,作为健康组,对比两组的BDNF进行对比分析。同时又按照BDNF的中位数水平进行分组,分为BDNF≥3.45组和BDNF<3.45组,对患者的基本资料,运动障碍包括下肢运动、平衡功能、行走功能,神经功能恶化标志物进行对比分析;利用Spearman进行H-FABP、MBP及BDNF与临床资料的相关性分析。结果研究组的BDNF表达显著低于健康组(P<0.05);BDNF≥3.45组中肢体功能评分(FMA)、姿势控制量表(PASS)明显高于BDNF<3.45组(P<0.05),BDNF≥3.45组中FAC(0级-3级占比)显著低于BDNF<3.45组(P<0.05);BDNF≥3.45组中心肌型脂肪酸结合蛋白(H-FABP)、碱性髓鞘蛋白(MBP)、淀粉样蛋白A(SAA)的水平明显高于BDNF<3.45组的水平(P<0.05),BDNF≥3.45组中B型钠尿肽前体(pro-BNP)、神经元特异性烯醇化酶(NSE)、胰岛素样生长因子1(IGF-1)的水平明显低于BDNF<3.45组的水平(P<0.05);心肌型脂肪酸结合蛋白(H-FABP)、MBP及BDNF与患者的性别、年龄、BMI、吸烟、饮酒、糖尿病史、高血压病史、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、肌酐(Cr)、尿酸(UA)、尿素氮(BUN)、同型半肤氨酸(Hcy)、糖化血红蛋白(HbA1c)无相关性(P>0.05),H-FABP、MBP与FMA评分、PASS评分、FAC(0级-3级占比)、pro-BNP、IGF-1呈现负相关(P<0.05),H-FABP、MBP与SAA呈现正相关(P<0.05);BDNF与FMA评分、PASS评分、FAC(0级-3级占比)、pro-BNP、IGF-1呈现正相关(P<0.05),H-FABP、MBP与SAA呈现负相关(P<0.05)。结论ACI后,H-FABP和MBP的表达升高,BDNF的表达降低,并与运动障碍及神经功能恶化具有一定的相关性。

Objective To investigate the correlation between dyskinesia and neurological deterioration and H-FABP,MBP and BDNF after acute cerebral infarction(ACI).Methods A total of 130 patients who were admitted to our hospital for neurological treatment and diagnosed with ACI from October 2018 to September 2019 were selected as the study group.At the same time,30 patients who were healthy during the same period of physical examination were selected as the healthy group,and the BDNF of the two groups were compared.Perform comparative analysis.At the same time,they were divided into groups according to the median level of BDNF.They were divided into BDNF≥3.45 group and BDNF<3.45 group.The basic data of patients were compared,and dyskinesias included lower limb movement,balance function,walking function,and markers of neurological deterioration;Use Spearman to analyze the correlation between H-FABP,MBP and BDNF and clinical data.Results The expression of BDNF in the study group was significantly lower than that in the healthy group(P<0.05);FMA and PASS were significantly higher in the BDNF≥3.45 group than in the BDNF<3.45 group(P<0.05),and the FAC(Grade 0 to 3)was significantly lower than the group with BDNF<3.45(P<0.05);the levels of H-FABP,MBP,SAA in the group with BDNF≥3.45 were significantly higher than those in the group with BDNF<3.45(P<0.05);The levels of pro-BNP,NSE,and IGF-1 were significantly lower than those in the BDNF<3.45 group(P<0.05);H-FABP,MBP,and BDNF were related to the gender,age,BMI,smoking,drinking,history of diabetes,high Blood pressure history,TC,TG,HDL-C,LDC-C,Cr,UA,BUN,Hcy,HbA1C have no correlation(P>0.05),H-FABP,MBP and FMA score,PASS score,FAC(Grade 0-Grade 3 ratio),pro-BNP,IGF-1 showed negative correlation(P<0.05),H-FABP,MBP and SAA showed positive correlation(P<0.05);BDNF and FMA score,PASS score,FAC(Grade 0-3 ratio),pro-BNP,IGF-1 showed a positive correlation(P<0.05),H-FABP,MBP and SAA showed a negative correlation(P<0.05).Conclusions After ACI,the expressions of H-FABP and MBP are increased,and the expression of BDNF is reduced,which is related to the dyskinesia and neurological deterioration.