AIS患者血清BDNF、MCP-1表达与认知功能障碍的相关性分析

Correlation analysis of serum BDNF,MCP-1 expression and cognitive dysfunction in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)患者血清脑源性神经营养因子(BDNF)、单核细胞趋化蛋白-1 (MCP-1)表达与卒中后认知功能障碍(PSCI)的相关性。方法选取356例AIS患者,根据蒙特利尔认知量表(MoCA)分为PSCI组(160例)和非PSCI组(196例)。观察两组AIS部位及血清BDNF、MCP-1表达情况,分析血清BDNF、MCP-1检测对PSCI的预测价值。结果PSCI组在额叶、颞叶梗死的发生率显著高于非PSCI组(P<0.05),且PSCI组血清BDNF水平显著低于非PSCI组,血清MCP-1水平高于非PSCI组(P<0.05)。PSCI患者血清BDNF水平与MoCA评分呈正相关,血清MCP-1水平与MoCA评分呈负相关关系(P<0.05)。血清BDNF、MCP-1单独检测的ROC曲线下面积(AUC)为0.829、0.849,联合检测的AUC及预测灵敏度均高于BDNF、MCP-1单独检测(P<0.05)。结论额叶、颞叶部位发生脑卒中患者PSCI发生率较高,血清BDNF、MCP-1检测对预测PSCI发生具有一定参考价值。

Objective To investigate the correlation between the expression of serum brain-derived neurotrophic factor(BDNF),monocyte chemotactic protein-1(MCP-1) and post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS).Methods A total of 258 patients with AIS were selected and divided into PSCI group(160 cases) and non-PSCI group(196 cases) according to the Montreal Cognitive Assessment(MoCA).The sites of cerebral infarction and the expression of serum BDNF and MCP-1 in the two groups were observed.The value of serum BDNF and MCP-1 detection in predicting of PSCI was analyzed.Results The incidence of frontal lobe and temporal lobe infarction in PSCI group was significantly higher than that in non-PSCI group(P<0.05).The level of serum BDNF in PSCI group was significantly lower than that in non-PSCI group,while the level of MCP-1 was higher than that in non-PSCI group(P<0.05).The level of serum BDNF was positively correlated with MoCA score in PSCI patients,while serum MCP-1 level was negatively correlated with MoCA score(P<0.05).The area under the ROC curve(AUC) of serum BDNF and MCP-1 detected separately was 0.829 and 0.849,and the AUC and predictive sensitivity of the combined detection were higher than those of BDNF and MCP-1 detected separately(P<0.05).Conclusion The incidence of PSCI in patients with cerebral apoplexy in frontal and temporal lobes is high.The detection of serum BDNF and MCP-1 has certain reference value in predicting the occurrence of PSCI.