脑小血管病患者血清CTRP1和同型半胱氨酸水平对血管性轻度认知障碍预测价值的研究

Study on the Predictive Value of Serum CTRP1 and Homocysteine Levels in Patients with Cerebral Small Vessel Diseases in Vascular Mild Cognitive Impairment

目的探讨血补体C1q/肿瘤坏死因子相关蛋白1(CTRP1),血同型半胱氨酸(Homocysteine,Hcy)预测脑小血管疾病(cerebral small vessel disease,CSVD)患者血管性轻度认知障碍(vascular mild cognitive impairment,VaMCI)的临床价值。方法选取2015年12月~2019年12月沧州市人民医院收治的98例CSVD患者,采用蒙特利尔评估表(Montreal cognitive assessment,MoCA)对其进行认知能力检查,分为VaMCI组(n=56)和认知正常组(n=42)。分别采取Logistic回归分析以及Pearson相关性分析CTRP1、血同型半胱氨酸与VaMCI之间的相关性。结果VaMCI组Hcy,CTRP1以及UA水平均高于认知正常组(Hcy:22.02±3.74μmol/L vs 18.43±3.52μmol/L,CTRP1:162.54±14.85ng/ml vs 135.26±13.41ng/ml,UA:360.27±23.28μmol/L vs 320.55±20.23μmol/L),差异均有统计学意义(t=4.822,9.377,8.833,均P<0.001)。Logistic回归分析结果显示Hcy,CTRP1,UA均是CSVD患者发生VaMCI的危险因素(Hcy:OR=2.782,95%CI:1.515~5.107,P=0.001;CTRP1:OR=3.401,95%CI:1.729~6.687,P=0.000;UA:OR=2.335,95%CI:1.325~4.114,P=0.003);且VaMCI组患者Hcy,CTRP1均与MoCA总分呈负相关(r=-0.415,-0.467,均P<0.05);另VaMCI组患者Hcy,CTRP1水平与记忆、语言以及视空间与执行能力等亚项均呈负相关(r=-0.402,-0.436;-0.365,-0.379;-0.512,-0.536,均P<0.05)。结论CSVD患者伴VaMCI的血清CTRP1,Hcy表达水平明显升高,且两者均属于CSVD患者发生VaMCI的独立危险因素,均与患者的MoCA总分、记忆、语言以及视空间与执行能力呈显著负相关性,早期检测CSVD血清CTRP1和Hcy水平对于预防认知功能障碍发生具有一定价值。

Objective To investigate the clinical value of vascular mild cognition in patients with cerebral small vessel disease(CSVD)by blood complement C1q/tumor necrosis factor related protein 1(CTRP1)and blood homocysteine(Hcy)in predicting vascular mild cognitive impairment(VaMCI)in patients with cerebral small blood vessels.Methods From December 2015 to December 2019,98 CSVD patients admitted to Cangzhou People’s Hospital were selected as the research subjects,and their cognitive abilities were examined using the Montreal cognitive assessment(MoCA).There were 56 cases in VaMCI group,42 cases in normal cognitive group and 60 cases in healthy control group.Logistic regression analysis and Pearson correlation analysis were used to analyze the correlation between CTRP1,blood homocysteine and VaMCI.Results The levels of Hcy,CTRP1 and UA in the VaMCI group were higher than those in the cognition normal group(Hcy:22.02±3.74μmol/L vs 18.43±3.52μmol/L,CTRP1:162.54±14.85ng/ml vs 135.26±13.41ng/ml,UA:360.27±23.28μmol/L vs 320.55±20.23μmol/L),the differences were statistically significant(t=4.822,9.377,8.833,P<0.001).Logistic regression analysis results showed that Hcy,CTRP1 and UA were all risk factors for VaMCI in CSVD patients(Hcy:OR=2.782,95%CI:1.515~5.107,P=0.001;CTRP1:OR=3.401,95%CI:1.729~6.687,P=0.000;UA:OR=2.335,95%CI:1.325~4.114,P=0.003);and that in VaMCI group,Hcy and CTRP1 were negatively correlated with MoCA total score(r=-0.415,-0.467,P<0.05).In the VaMCI group,Hcy and CTRP1 levels were negatively correlated with sub-items such as memory,language,visual space,and executive ability(r=-0.402,-0.436;-0.365,-0.379;-0.512,-0.536,all P<0.05).Conclusion CSVD patients with VaMCI serum CTRP1 and Hcy expression levels were significantly increased,and both are independent risk factors for VaMCI in CSVD patients,both of which are significantly related to the patient’s MoCA total score,memory,language,visual space and executive ability.Early detection of CSVD serum CTRP1 and Hcy levels are of great significance for preventing cognitive dysfunction.