脑白质疏松患者睡眠障碍与血清NSE、HIF-1α、BDNF的相关性研究

Study on correlation between sleep disturbance and serum NSE,HIF-1α,and BDNF in patients with leukoaraiosis

目的 分析脑白质疏松患者睡眠障碍与血清神经元特异性烯醇化酶(NSE)、缺氧诱导因子-1α(HIF-1α)、脑源性神经营养因子(BDNF)水平的相关性。方法 选取147例脑白质疏松患者作为病例组,根据患者的脑白质疏松严重程度分为轻度组(48例)、中度组(48例)以及重度组(51例);另选取同期48例体检头颅磁共振成像(MRI)证实无脑白质疏松者且6个月内无重大疾病者为对照组。比较对照组、轻度组、中度组、重度组血清NSE、HIF-1α、BDNF水平及匹兹堡睡眠质量指数量表(PSQI)评分,不同睡眠质量患者血清NSE、HIF-1α、BDNF水平及Fazekas评分;分析血清NSE、HIF-1α、BDNF的表达与PSQI、Fazekas评分的相关性。结果 对照组血清NSE、HIF-1α、BDNF水平及PSQI评分分别为(10.82±4.03)ng/ml、(184.29±35.73)pg/ml、(13.02±1.92)ng/ml、(3.75±1.75)分,轻度组分别为(14.80±2.22)ng/ml、(284.58±31.74)pg/ml、(11.70±1.46)ng/ml、(5.08±1.69)分,中度组分别为(16.01±2.71)ng/ml、(319.07±40.45)pg/ml、(9.91±0.93)ng/ml、(10.04±2.65)分,重度组分别为(23.78±4.36)ng/ml、(347.18±60.03)pg/ml、(8.05±1.32)ng/ml、(13.14±3.61)分。轻度组、中度组、重度组血清NSE、HIF-1α水平以及PSQI评分均高于对照组,血清BDNF水平低于对照组,差异具有统计学意义(P<0.05);中度组和重度组血清NSE、HIF-1α及PSQI评分均高于轻度组,血清BDNF水平低于轻度组,差异具有统计学意义(P<0.05);重度组血清NSE、HIF-1α及PSQI评分均高于中度组,血清BDNF水平低于中度组,差异具有统计学意义(P<0.05)。随着睡眠质量逐渐下降,NSE、HIF-1α水平及Fazekas评分逐渐上升,BDNF水平逐渐下降;睡眠质量很好组、睡眠质量还行组、睡眠质量一般组及睡眠质量很差组NSE、HIF-1α、BDNF水平及Fazekas评分比较差异具有统计学意义(P<0.05)。Pearson线性相关分析提示,PSQI评分与血清NSE、HIF-1α呈正相关(r=0.629、0.579,P<0.05),与血清BDNF呈负相关(r=-0.675,P<0.05);Fazekas评分与血清NSE、HIF-1α、PSQI评分呈正相关(r=0.781、0.748,0.793,P<0.05),与血清BDNF水平呈负相关(r=-0.805,P<0.05)。结论 脑白质疏松患者血清NSE、HIF-1α、BDNF水平表达异常,且是脑白质疏松发生睡眠障碍的影响因素。

Objective To analyze the correlation between sleep disturbance and serum neuron-specific enolase(NSE),hypoxia-inducible factor-1α(HIF-1α),brain-derived neurotrophic factor(BDNF)in patients with leukoaraiosis.Methods 147 cases of leukomalacia patients were selected as the case group,and the patients were divided into mild group(48 cases),moderate group(48 cases)and severe group(51 cases)according to the severity of leukomalacia.Another 48 cases had no leukoaraiosis by cranial magnetic resonance imaging(MRI)during the same period and no major diseases within 6 months were selected as the control group.Comparison was made on serum NSE,HIF-1α,BDNF levels and Pittsburgh Sleep Quality Index scale(PSQI)score in the control group,mild group,moderate group and severe group group,as well as serum NSE,HIF-1α,BDNF levels and Fazekas score in patients with different sleep quality.The correlation between the expression of serum NSE,HIF-1α,BDNF and PSQI and Fazekas score was analyzed.Results The serum NSE,HIF-1α,BDNF levels and PSQI score were(10.82±4.03)ng/ml,(184.29±35.73)pg/ml,(13.02±1.92)ng/ml,and(3.75±1.75)points in the control group,(14.80±2.22)ng/ml,(284.58±31.74)pg/ml,(11.70±1.46)ng/ml,and(5.08±1.69)points in the mild group,(16.01±2.71)ng/ml,(319.07±40.45)pg/ml,(9.91±0.93)ng/ml,and(10.04±2.65)points in the moderate group,and(23.78±4.36)ng/ml,(347.18±60.03)pg/ml,(8.05±1.32)ng/ml,and(13.14±3.61)points in the severe group.The serum NSE,HIF-1αlevels and PSQI score in the mild group,moderate group and severe group were higher than than those in the control group,and serum BDNF level was lower than that in the control group.The differences were statistically significant(P<0.05).The serum NSE,HIF-1αand PSQI score in the moderate group and severe group were higher than those in the mild group,and serum BDNF level was lower than that in the mild group.The differences were statistically significant(P<0.05).The serum NSE,HIF-1αand PSQI score in the severe group were higher than those in the moderate group,and the serum BDNF level was lower than that in the moderate group.The differences were statistically significant(P<0.05).With the decrease of sleep quality,NSE,HIF-1αand Fazekas scores were increased,while BDNF levels were decreased.There were statistically significant differences in NSE,HIF-1α,BDNF and Fazekas scores among good sleep quality group,fair sleep quality group,average sleep quality group and poor sleep quality group(P<0.05).Pearson linear correlation analysis suggested that PSQI score was positively correlated with serum NSE and HIF-1α(r=0.629,0.579;P<0.05)and negatively correlated with serum BDNF(r=-0.675,P<0.05).Fazekas score was positively correlated with serum NSE,HIF-1α,and PSQI score(r=0.781,0.748,0.793;P<0.05)and negatively correlated with serum BDNF levels(r=-0.805,P<0.05).Conclusion The serum levels of NSE,HIF-1αand BDNF are abnormal in leukoaraiosis patients,and they are independent factors influencing the development of sleep disorders in leukoaraiosis patients.