血清β_(2)微球蛋白升高对脑小血管病患者脑白质损害的作用

Effect of elevated serumβ_(2) microglobulin of brain white matter damage in patients with cerebral small vessel disease

目的β_(2)微球蛋白与脑小血管病患者脑白质高信号严重程度的关系尚未明确。文中探讨β_(2)微球蛋白等血清标志物及临床相关危险因素与脑小血管病患者脑白质高信号严重程度的相关性。方法回顾性分析2020年1月至2021年1月在联勤保障部队第九四〇医院神经内科住院的头颅MRI主要表现为脑白质高信号的脑小血管病患者临床资料。使用Fazekas量表和改良Scheltens量表对纳入患者头颅核磁脑白质高信号的严重程度进行分级。两量表评估结果一致的患者被纳入研究,并按脑白质高信号严重程度将患者分为轻度组和中重度组,比较组间差异。采用多因素Logistic回归法分析缺血性脑小血管病患者脑白质病变严重程度的危险因素。结果研究共纳入222例患者,其中轻度组112例(50.45%),中重度组110例(49.55%)。中重度组患者年龄、高血压、β_(2)微球蛋白、同型半胱氨酸、D-二聚体显著高于轻度组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄(OR=1.088,95%CI:1.05~1.127)、高血压(OR=2.576,95%CI:1.116~5.946)、血清同型半胱氨酸(OR=1.037,95%CI:1.005~1.07)、β_(2)微球蛋白(OR=1.685,95%CI:1.04~2.731)、D-二聚体(OR=3.587,95%CI:1.219~10.55)是脑白质病变严重程度的独立危险因素。结论β_(2)微球蛋白对脑白质高信号的严重程度具有预测价值。此外,血清同型半胱氨酸、D-二聚体、年龄、高血压也是脑白质高信号严重程度的独立危险因素。

Objective Previous studies have found thatβ_(2)microglobulin is related to cerebral small vessel disease,but the relationship betweenβ_(2)microglobulin and the severity of cerebral white matter hyperintensity in patients with cerebral small vessel disease has not been clarified.Therefore,the correlation between serum markers such asβ_(2)microglobulin and clinical related risk factors and the severity of white matter hyperintensity in patients with cerebral small vessel disease was studied in the paper.Methods Selected patients with cerebral small vascular disease who were hospitalized in the Department of Neurology of the 940 Hospital of the Joint Logistics Service Force from January 2020 to January 2021,who mainly showed cerebral white matter hyperintensity.The severity of the brain magnetic white matter hyperintensity in the included patients was graded using the Fazekas scale and the modified Scheltens scale.Patients with the same evaluation results of the two scales were included in the study,and the patients were divided into mild and moderate severe groups according to the severity of white matter hyperintensity,and the differences between the groups were compared.Multivariate Logistic regression was used to analyze the risk factors of the severity of white matter lesions in patients with ischemic cerebrovascular disease.Results A total of 222 patients were included in the study,including 112(50.45%)in the mild group and 110(49.55%)in the moderate to severe group.In the moderate to severe group,age,hypertension,β_(2)microglobulin,homocysteine,D-dimer was significantly higher than the mild group,the difference was statistically significant(P<0.05);multivariate logistic regression analysis showed that age(OR 1.088,95%CI 1.05~1.127),hypertension(OR 2.576,95%CI 1.116~5.946),serum homocysteine(OR 1.037,95%CI 1.005~1.07),β_(2)microglobulin(OR 1.685,95%CI 1.04~2.731)and D-dimer(OR 3.587,95%CI 1.219~10.55)are independent risk factors for the severity of white matter lesions.Conclusionβ_(2)microglobulin has predictive value for the severity of white matter hyperintensity.In addition,serum homocysteine,D-dimer,age,and hypertension are also independent risk factors for the severity of white matter hyperintensity.