血清几丁质酶3样蛋白1、MMP-9与脑白质高信号的相关性

Correlation analysis among serum Chitinase-3-like protein 1,MMP-9 and white matter hypersignal

目的通过检测血清炎性因子几丁质酶3样蛋白1(YKL-40)、MMP-9水平,探讨其与脑白质高信号(WMH)的相关性,为WMH的发病机制和预防治疗提供新思路。方法选取2020年12月至2022年6月在郑州大学第二附属医院神经内科就诊的WMH患者120例,行头颅磁共振成像评估WMH严重程度,根据Fazekas量表评分将患者分为轻度组(1~2分,42例)、中度组(3~4分,51例)、重度组(5~6分,27例)。收集患者的一般资料、实验室检查指标,采用酶联免疫吸附试验(ELISA)测定患者血清YKL-40、MMP-9水平并进行比较分析。WMH严重程度影响因素采用有序logistic回归分析;YKL-40、MMP-9水平与WMH严重程度相关性采用Spearman相关性分析。结果轻度组高血压患病率显著低于中度组、重度组,差异有统计学意义(P<0.05);3组间年龄、血清YKL-40、MMP-9水平两两比较差异均有统计学意义(P<0.05)。有序logistic回归分析结果显示:血清YKL-40(OR=1.15,95%CI:0.003~0.286,P<0.05)、血清MMP-9(OR=1.26,95%CI:0.138~0.329,P<0.05)升高是WMH严重程度的独立危险因素。Spearman相关性分析结果显示:血清YKL-40(r=0.811,P<0.05)、MMP-9(r=0.913,P<0.05)水平与WMH严重程度呈正相关。结论血清YKL-40、MMP-9水平与WMH严重程度呈正相关,有助于预测WMH的严重程度、明确发病机制并为其治疗预防提供新思路。

Objective To provide a new ideas for the pathogenesis,prevention and treatment of white matter hyperintensity(WMH)by detecting the correlation between serum inflammatory factors of YKL-40/MMP-9 and WMH.Methods From December 2020 to June 2022,120 patients with WMH who were hospitalized in the Department of Neurology of the Second Affiliated Hospital of Zhengzhou University were selected.The severity of WMH was evaluated by cranial magnetic resonance imaging.According to Fazekas score,the patients were divided into mild group(42 cases)(1-2 points),moderate group(51 cases)(3-4 points),and severe group(27 cases)(5-6 points).The general data and laboratory examination indexes of the patients were collected,and the serum YKL-40 and MMP-9 levels were determined by enzyme-linked immunosorbent assay(ELISA).The influencing factors of WMH severity were analyzed by ordinal logistic regression.Spearman correlation analysis was used to analyze the correlations between YKL-40/MMP-9 levels and WMH severity.Results The prevalence of hypertension in mild group was significantly higher than those in moderate group and severe group(P<0.05).The age,and serum YKL-40 and MMP-9 levels in the three groups were significantly different(P<0.05).The results of ordered logistic regression analysis showed that the increase of serum YKL-40(OR=1.15,95%CI:0.003-0.286,P<0.05)and serum MMP-9(OR=1.26,95%CI:0.138-0.329,P<0.05)were the risk factors for the severity of WMH.Spearman correlation analysis showed that serum YKL-40(r=0.811,P<0.05),and MMP-9(r=0.913,P<0.05)levels were positively correlated with the severity of WMH.Conclusion The levels of serum YKL-40/MMP-9 are positively correlated with the severity of WMH,which is helpful to predict the severity of WMH,clarify the pathogenesis and provide new ideas for its treatment and prevention.