血清Klotho蛋白水平与缺血性脑卒中致血管性痴呆的相关性分析

Analysis of the correlation between serum Klotho protein level and vascular dementia induced by ischemic stroke.

目的探讨血清Klotho蛋白水平与缺血性脑卒中致血管性痴呆的相关性。方法回顾性分析2017年2月至2018年1月宜昌市中心医院收治的126例缺血性脑卒中患者资料。所有患者在发病后3个月复诊,分为血管性痴呆(痴呆组)60例和非痴呆组66例。观察并比较2组患者一般情况、血清中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等血脂水平、体内超敏C反应蛋白(hs-CRP)、高半胱氨酸(Hcy)及Klotho蛋白水平、简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评分;缺血性脑卒中致血管性痴呆的危险因素;MMSE和MoCA评分与Klotho蛋白水平的相关性。结果痴呆组患者年龄、饮酒例数、梗死范围高于非痴呆组,差异均有统计学意义(P<0.05);2组患者血清中TC、TG、HDL、LDL水平比较,差异无统计学意义(P>0.05);痴呆组患者体内hs-CRP、Hcy水平为(4.98±0.86)mg/L、(18.36±10.42)μmol/L,明显高于非痴呆组[(4.57±0.92)mg/L、(13.52±11.36)μmol/L],差异均有统计学意义(P<0.05);痴呆组患者血清中Klotho蛋白(165.69±96.68)pg/mL,水平明显低于非痴呆组[(324.64±87.63)pg/mL],差异有统计学意义(P<0.05);痴呆组患者MMSE和MoCA评分为(15.32±4.21)、(18.69±3.65)分,明显低于非痴呆组[(21.36±3.67)、(24.72±3.21)分],差异均有统计学意义(P<0.05);年龄、hs-CRP、Hcy及Klotho蛋白水平为缺血性脑卒中致血管性痴呆的密切相关因素(P<0.05);高血脂和大面积梗死为缺血性脑卒中致血管性痴呆的可能相关因素;Klotho蛋白与MMSE评分呈负相关(r=-0.436,P<0.05);Klotho蛋白与MoCA评分呈负相关(r=-0.415,P<0.05)。结论Klotho蛋白水平与缺血性脑卒中致血管性痴呆密切相关,可作为缺血性脑卒中后预测血管性痴呆的标志物。

Objective To investigate the correlation between serum Klotho protein level and vascular dementia induced by ischemic stroke.Methods The clinical data of 126 patients with ischemic stroke admitted to Yichang Central Hospital from February 2017 to January 2018 were retrospectively analyzed.They were divided into dementia group(n=60)and non-dementia group(n=66).General condition,serum total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),Klotho protein levels,mini-mental state examination(MMSE)and Montreal cognitive assessment scale(MoCA)were observed and compared.Risk factors of vascular dementia induced by ischemic stroke were analyzed,and the correlation between MMSE and MoCA scores and Klotho protein levels were discussed.Results The age,number of drinking cases and the range of infarction in the dementia group were higher than those in the non-dementia group,and the differences were statistically significant(P<0.05).The differences of serum TC,TG,HDL and LDL levels between the two groups were not statistically significant(P>0.05).The levels of hs-CRP and Hcy in the dementia group were(4.98±0.86)mg/L and(18.36±10.42)μmol/L,which were significantly higher than those in the non-dementia group[(4.57±0.92)mg/L,(13.52±11.36)μmol/L],the differences were statistically significant(P<0.05);the serum Klotho protein(165.69±96.68)pg/mL in the dementia group was significantly lower than that in the non-dementia group[(324.64±87.63)pg/mL],the difference was statistically significant(P<0.05);the scores of MMSE and MoCA in the dementia group were(15.32±4.21)points and(18.69±3.65)points,which were significantly lower than those in the non-dementia group[(21.36±3.67),(24.72±3.21)points],the differences were statistically significant(P<0.05);Age,hs-CRP,Hcy and Klotho protein levels were closely related to vascular dementia in ischemic stroke(P<0.05).High blood lipid and large area infarction were possible related factors of ischemic stroke caused by vascular dementia;Klotho protein was negatively correlated with the MMSE score(r=-0.436,P<0.05)and MoCA score(r=-0.415,P<0.05).Conclusion Klotho protein level is closely related to vascular dementia induced by ischemic stroke,so it can be used as a marker to predict vascular dementia after ischemic stroke.