脑小血管病所致血管性认知功能障碍患者VEGF hs-CRP水平及脑血流灌注的临床意义

Clinical significance of VEGF and hs-CRP levels and cerebral blood perfusion in patients with vascular cognitive impairment caused by cerebral small vessel disease

目的探讨脑小血管病所致血管性认知功能障碍(VCI)患者血管内皮生长因子(VEGF)、超敏C反应蛋白(hs-CRP)水平及脑血流灌注的临床意义。方法选取达州市中西医结合医院2018-01—2021-03收治的125例脑小血管病患者,分为认知障碍患者79例(A组)和认知正常患者46例(B组),选取无脑小血管病史的健康志愿者30例为C组。比较VEGF、hs-CRP、脑血流灌注、MMSE评分、MoCA评分。分析脑小血管病认知功能与各指标的相关性。结果A组的MMSE评分(22.71±3.02)分、MoCA评分(21.33±2.36)分、血清VEGF水平(166.28±33.57)ng/L、脑血流速度(CBFV)(88.63±15.49)cm/s、脑血流量(CBF)(673.42±50.33)m L/s,低于B组(27.82±0.63)分、(25.45±1.86)分、(194.60±38.12)ng/L、(95.22±17.63)cm/s、(733.68±58.11)m L/s,C组(28.05±0.56)分、(26.03±1.52)分、(216.53±42.30)ng/L、(101.66±20.41)cm/s、(759.12±64.08)mL/s(P<0.05),A组的血清hs-CRP水平(3.52±1.12)mg/L高于B组(2.87±0.95)mg/L、C组(2.05±0.41)mg/L(P<0.05)。MMSE评分、MoCA评分与VEGF、CBFV、CBF呈正相关(r=0.571,r=0.422,r=0.439,r=0.410,r=0.378,r=0.355),与hs-CRP呈负相关(r=—0.173,r=—0.256)。结论血清VEGF低水平、hs-CRP高水平、脑血流低灌注与脑小血管病所致VCI密切相关,可能是导致VCI的机制。

Objective To investigate the clinical significance of vascular endothelial growth factor(VEGF)and high-sensitivity C-reactive protein(hs-CRP)levels and cerebral blood perfusion in patients with vascular cognitive impairment(VCI)caused by cerebral small vessel disease(CSVD).Methods This research enrolled 125 patients with CSVD admitted to the hospital between January 2018 and March 2021.According to the presence or absence of VCI,the patients were divided into 79 patients with cognitive impairment(group A)and46 patients with normal cognition(group B).Meanwhile,30 healthy volunteers were selected as the group C.Serum VEGF and hs-CRP levels,cerebral blood perfusion indicators,Mini Mental State Examination(MMSE)scores,and Montreal Cognitive Assessment(MoCA)scores were compared between the groups,and correlations among above items were analyzed.Results The MMSE scores,MoCA scores,serum VEGF,mean cerebral blood flow velocity(CBFV)and mean cerebral blood flow(CBF)of the group A were lower than those of the group B and the group C(22.71±3.02 vs 27.82±0.63 vs 28.05±0.56)scores;(21.33±2.36 vs 25.45±1.86 vs 26.03±1.52)scores;(166.28±33.57 vs 194.60±38.12 vs 216.53±42.30)ng/L;(88.63±15.49 vs 95.22±17.63 vs 101.66±20.41)cm/s;(673.42±50.33 vs 733.68±58.11 vs 759.12±64.08)mL/s(P<0.05),and serum hs-CRP level was higher than those in the group B and the group C(3.52±1.12 vs 2.87±0.95 vs 2.05±0.41)mg/L(P<0.05).The MMSE score,MoCA score,serum VEGF,CBFV and CBF of patients with CSVD were positively correlated with serum VEGF level(r=0.571,r=0.422,r=0.439,r=0.410,r=0.378,r=0.355),were negatively correlated with serum hs-CRP level(r=-0.173,r=-0.256).Conclusion Low serum VEGF level,high hs-CRP level,and cerebral blood flow hypoperfusion are closely related to VCI caused by CSVD,which may be the mechanism leading to VCI.