缺血性脑卒中患者外周血TREM-1、MCP-1水平与血管性痴呆的相关性

Relationship between expression levels of TREM-1 and MCP-1 in peripheral blood and vascular dementia in patients with ischemic stroke

目的探讨缺血性脑卒中患者外周血髓系细胞触发受体-1(TREM-1)、单核细胞趋化蛋白-1(MCP-1)水平与其发生血管性痴呆(VaD)之间的相关性。方法100例缺血性脑卒中老年患者为观察组,另选择同期100例健康体检者为对照组。检测观察组患者入院时、入院第1天、第3天、第5天及第7天血清TREM-1、MCP-1水平,对照组体检当天测定血清TREM-1及MCP-1水平。根据蒙特利尔认知评估量表(MoCA)评分将观察组分为无VaD组,轻度、中度和重度VaD组,通过Pearson单因素分析和Loglist回归分析血清MCP-1、TREM-1水平与患者血管性痴呆的相关性,并采用ROC下面积(AUC)分别评价单项指标对患者疾病的预后评估价值。结果观察组患者MCP-1、TREM-1水平及合并高血压病史人数均高于对照组(P<0.05)。观察组患者血清MCP-1和TREM-1水平入院第3天、第5天、第7天较入院时和入院第1天降低(P<0.05)。与无VaD组比较,其他组MEP-1和TREM-1水平升高,重度组MCP-1和TREM-1水平高于中度组和轻度组(P<0.05)。缺血性脑卒中患者MoCA评分与血清MCP-1、TREM-1水平呈负相关(r=-0.336、-0.734,P<0.05)。MCP-1、TREM-1水平均是影响缺血性脑卒中患者发生血管性痴呆的独立危险因素(P<0.05)。TREM-1 AUC为0.840,MCP-1 AUC为0.735(P<0.05)。结论缺血性脑卒中患者血清MCP-1、TREM-1水平与血管性痴呆呈负相关,均为影响缺血性脑卒中患者发生血管性痴呆的独立危险因素,对评估缺血性脑卒中患者病情程度、预测预后有重要参考作用。

Aim To investigate the correlation between the expression levels of triggering receptor expressed on myeloid cells-1(TREM-1)and monocyte chemoattractant protein-1(MCP-1)in peripheral blood myeloid cells and vascular dementia(VaD)in patients with ischemic stroke.Methods 100 elderly patients with ischemic stroke were selected as the observation group,and 100 healthy people in the same period were selected as the control group.The serum levels of TREM-1 and MCP-1 in the observation group were measured at admission,on the first day,the third day,the fifth day and the seventh day of admission,and the serum levels of TREM-1 and MCP-1 in the control group were measured on the day of physical examination.According to the score of Montreal Cognitive Assessment Scale(MoCA),the observation group was divided into non VaD group,mild group,moderate group and severe group of VaD.The correlation between the levels of serum MCP-1 and TREM-1 and vascular dementia was analyzed by Pearson univariate analysis and Loglist regression,and the area under the ROC(AUC)was used to evaluate the prognostic value of single indicators.Results The levels of MCP-1 and TREM-1 in the observation group were significantly higher than those in the control group,and the number of patients with hypertension were more than those in the control group(P<0.05).The serum of MCP-1 in the observation group decreased on the 3rt,5th and 7th day after admission compared with those at the time of admission and the 1st day after admission(P<0.05).Compared with the non VaD group,the levels of MCP-1 and TREM-1 in other groups increased,and the levels of MCP-1 and TREM-1 in severe group were higher than those in moderate group and mild group(P<0.05).There was a negative correlation between MoCA score and serum MCP-1 and TREM-1 levels in patients with ischemic stroke(r=-0.336,-0.734,P<0.05).MCP-1 and TREM-1 levels were independent risk factors for vascular dementia in patients with ischemic stroke(P<0.05).The AUC detected by TREM-1 was 0.840 and that detected by MCP-1 was 0.735(P<0.05).Conclusion The levels of serum MCP-1 and TREM-1 in patients with ischemic stroke are negatively correlated with vascular dementia.They are independent risk factors for vascular dementia in patients with ischemic stroke.They play an important reference role in evaluating the severity of ischemic stroke,predicting prognosis.