脑小血管病血清程序性细胞死亡因子4蛋白水平与认知功能障碍的相关性分析

A correlation analysis of serum PDCD4 protein level and cognitive dysfunction in cerebral small vessel disease

目的 探讨脑小血管病(CSVD)病人血清程序性细胞死亡因子4(PDCD4)蛋白水平与认知功能障碍的相关性。方法2019年1月至2021年1月开封大学附属医院CSVD病人96例作为研究对象(观察组),同期健康体检者100例为对照(对照组),收集两组性别、年龄、教育程度、吸烟、饮酒、高血压、糖尿病、生化指标(常规检测三酰甘油、高密度脂蛋白、低密度脂蛋白、总胆固醇、尿酸)水平。根据蒙特利尔认知评估量表(MoCA)评分将病人分为伴有认知障碍组和无认知障碍组。酶联免疫吸附测定(ELISA)检测受试者血清PDCD4蛋白水平;Spearman分析血清中PDCD4蛋白水平与MoCA评分、简易智力状态检查(MMSE)量表评分的相关性。采用多元线性回归分析PDCD4蛋白水平、MoCA评分、MMSE评分变化的影响因素。结果 观察组、对照组和无认知障碍组、伴有认知障碍组性别、年龄、教育程度、吸烟、饮酒、高血压、糖尿病史,三酰甘油、高密度脂蛋白、低密度脂蛋白、总胆固醇、尿酸水平差异无统计学意义(P>0.05)。与对照组相比,观察组血清中PDCD4蛋白水平升高[(47.62±6.65)μg/L比(21.36±3.87)μg/L,P<0.05],MoCA评分降低[(25.03±4.48)分比(28.68±2.16)分,P<0.05];与无认知障碍组相比,伴有认知障碍组血清中PDCD4蛋白水平升高[(49.35±5.87)μg/L比(44.46±6.54)μg/L,P<0.05],MoCA评分、MMSE评分降低[(23.63±2.15)分比(27.48±1.37)分,(17.22±3.41)分比(21.34±5.35)分,P<0.05]。Spearman分析结果显示,血清中PDCD4蛋白水平与MoCA评分、MMSE评分呈负相关。认知功能障碍是影响PDCD4蛋白水平、MoCA评分、MMSE评分变化的独立因素(P<0.05)。结论 CSVD病人血清中PDCD4蛋白高表达水平与认知功能障碍指标关系密切。

Objective To investigate the correlation between serum programmed cell death factor 4(PDCD4) protein level and cognitive dysfunction in patients with cerebral small vessel disease(CSVD).Methods A total of 96 patients with CSVD admitted to The Affiliated Hospital of Kaifeng University from January 2019 to January 2021 were included as the research objects(study group),and 100 healthy subjects were selected as the controls(control group) during the same period.Data of the two groups were collected,including gender,age,education level,smoking,drinking,high blood pressure,diabetes,and biochemical indicators(routine testing of triglycerides,high-density lipoprotein,low-density lipoprotein,total cholesterol,and uric acid).According to the Montreal Cognitive Assessment Scale(MoCA) scores,patients were assigned into the cognitive dysfunction group and non-cognitive dysfunction group.Enzymelinked immunosorbent(ELISA) method was used to detect the serum PDCD4 level of subjects;Spearman's rank correlation was used to analyze the correlation between serum PDCD4 level and MoCA total score as well as the Mini-Mental State Exam(MMSE) score.Multiple linear regression was used to analyze the influencing factors for PDCD4 level,MoCA score and MMSE score.Results No significant differences were found between the study group and the control group and between the non-cognitive dysfunction group and the cognitive dysfunction group in gender,age,education level,smoking,drinking,hypertension,diabetes history,triglycerides,high-density lipoprotein,low-density lipoprotein,total cholesterol and uric acid levels(P0.05).Compared with the control group,the serum PDCD4 level of the study group increased [(47.62±6.65) μg/L vs.(21.36±3.87) μg/L,P0.05],and the MoCA score decreased [(25.03±4.48) vs.(28.68±2.16),P0.05];compared with the non-cognitive dysfunction group,the serum PDCD4 level in the cognitive dysfunction group increased [(49.35±5.87) μg/L vs.(44.46±6.54) μg/L,P0.05],and the MoCA score,MMSE score decreased [(23.63±2.15) vs.(27.48±1.37),(17.22±3.41) vs.(21.34±5.35),P0.05].Spearman's correlation analysis showed that the serum PDCD4 level was negatively correlated with MoCA total score and MMSE score.Cognitive impairment was an independent factor affecting the level of PDCD4,MoCA total score and MMSE score(P0.05).Conclusion The expression of PDCD4in the serum of patients with CSVD is high,which is closely related to the indicators of cognitive dysfunction.