血管性痴呆患者VILIP-1、MMP-9、ApoE水平变化及危险因素分析

Changes of VILIP-1,MMP-9 and ApoE levels in patients with vascular dementia and risk factors analysis

目的探讨血管性痴呆(VD)患者视锥蛋白样蛋白1(VILIP-1)、基质金属蛋白酶-9(MMP-9)、载脂蛋白E(ApoE)的变化及危险因素。方法选取VD患者116例为VD组,无认知功能障碍的脑梗死患者110例为对照组。比较2组患者血清VILIP-1、MMP-9、ApoE水平及简易精神状态量表(MMSE)评分。采用简单线性相关法分析VILIP-1、MMP-9、ApoE水平与MMSE评分的相关性,采用单因素及多因素分析探讨血管性痴呆的危险因素。结果VD组入院时美国国立卫生研究院卒中量表(NIHSS)评分、脑梗死部位、梗死病灶大小、颈动脉斑块检出率与对照组比较,差异有统计学意义(P<0.05)。VD组血清VILIP-1、MMP-9、ApoE水平高于对照组,差异有统计学意义(P<0.05)。VD组定向力、注意力和计算力、记忆力、回忆能力、语言能力、MMSE总分高于对照组,差异有统计学意义(P<0.05)。VD组的血清VILIP-1、MMP-9、ApoE水平与MMSE总分均呈显著负相关(P<0.05)。Logistic回归模型结果显示,血清VILIP-1、MMP-9、ApoE水平增高,入院时NIHSS评分较高,额叶部位脑梗死以及大梗死病灶是脑梗死患者并发VD的独立危险因素(P<0.05)。结论血清VILIP-1、MMP-9、ApoE水平升高会增高脑梗死患者并发VD的风险,且与患者认知受损程度有关。

Objective To explore the changes of visinin-like protein 1(VILIP-1),matrix metalloproteinase-9(MMP-9)and apolipoprotein E(ApoE)levels in patients with vascular dementia(VD)and risk factors.Methods A total of 116 patients with VD were selected as VD group,and 110 patients with cerebral infarction without cognitive dysfunction were selected as control group.Serum levels of VILIP-1,MMP-9 as well as ApoE and Mini-Mental State Examination(MMSE)scores were compared between two groups.The correlations between VILIP-1,MMP-9,ApoE and MMSE score were analyzed by simple linear correlation method.The risk factors of vascular dementia were analyzed by univariate and multivariate analysis.Results At admission,National Institutes of Health Stroke Scale(NIHSS)scores,infarct site,infarct lesion size and carotid plaque detection rate in the VD group showed significant differences compared with those in the control group(P<0.05).The serum levels of VILIP-1,MMP-9 and ApoE in the VD group were significantly higher than those in control group(P<0.05).Orientation as well as attention and computation,memory,recall,language and MMSE scores in the VD group were significantly higher than those in control group(P<0.05).The serum levels of VILIP-1,MMP-9 and ApoE in the VD group were significantly negatively correlated with the total MMSE scores(P<0.05).The results of Logistic regression model showed increased levels of serum VilIP-1,MMP-9 and ApoE,NIHSS score was high at admission,cerebral infarction in the frontal lobe and large infarction lesions were independent risk factors for VD in patients with cerebral infarction(P<0.05).Conclusion Elevated serum levels of VILIP-1,MMP-9 and ApoE can increase the risk of VD in patients with cerebral infarction,and are related to the degree of cognitive impairment.