老年脑梗死后血管性痴呆病人血清AGEs、RAGE水平与病情严重程度的关系

Relationship of serum levels of AGEs and RAGE with dementia severity in elderly patients with vasculaRdementia afteRcerebral infarction

目的探讨老年脑梗死后血管性痴呆(CI-VD)病人血清晚期糖基化终末产物(AGEs)、晚期糖基化终末产物受体(RAGE)水平与病情严重程度的关系。方法选取2020年1月至2021年6月中国人民解放军中部战区总医院收治的96例老年CI-VD病人,另选取同期医院收治的84例老年单纯脑梗死(cerebral infarction,CI)病人,比较2组病人血清AGEs、RAGE水平。根据病情严重程度将老年CI-VD病人分为轻度组(n=25)、中度组(n=39)和重度组(n=32),比较3组病人血清AGEs、RAGE水平,采用Spearman秩相关分析血清AGEs、RAGE水平与病情严重程度的关系,采用Logistic回归分析老年CI-VD病人重度痴呆的影响因素,并采用ROC曲线分析血清AGEs、RAGE水平预测重度病情的价值。结果老年CI-VD病人血清AGEs、RAGE水平均高于老年单纯CI病人(P<0.01);血清AGEs、RAGE水平随着病情的加重而增加(P<0.05),Spearman相关性分析显示,血清AGEs(R=0.446,P<0.001)、RAGE(R=0.469,P<0.001)水平与病情严重程度呈正相关;多因素Logistic回归分析结果显示,受教育程度及血清神经元特异性烯醇化酶(NSE)、AGEs、RAGE水平均是影响老年CI-VD病人病情的独立相关因素(P<0.05);ROC曲线分析显示,老年CI-VD病人血清AGEs、RAGE预测重度痴呆的最佳截断值分别为33.07μg/mL和550.31μg/mL,两者联合预测重度病情的特异度和AUC分别为95.31%和0.855,高于单独预测价值(P<0.05)。结论老年CI-VD病人血清AGEs、RAGE水平与病情严重程度有关,临床检测其水平变化可作为预测病情变化的敏感指标。

Objective To investigate the relationship of serum advanced glycation end products(AGEs)and receptoRof AGEs(RAGE)with dementia severity in the patients with vasculaRdementia afteRcerebral infarction.Methods A total of 96 elderly patients with vasculaRdementia afteRcerebral infarction(CI-VD group)and 84 elderly patients with simple cerebral infarction(CI group)who were admitted to the Central TheateRCommand General Hospital from January 2020 to June 2021 were enrolled.The serum levels of AGEs and RAGE were compared between the two groups.According to the severity of dementia,the CI-VD patients were divided into mild group(n=25),moderate group(n=39)and severe group(n=32),and the serum levels of AGEs and RAGE were compared among the three groups.Spearman correlation was used to analyze the correlation of serum AGEs and RAGE levels with disease severity.Multivariate Logistic regression analysis was used to analyze the influencing factors of the severity of dementia.ReceiveRoperating characteristic(ROC)curve was used to analyze the value of serum AGEs and RAGE levels in predicting severe dementia in the elderly CI-VD patients.Results The serum levels of AGEs and RAGE in CI-VD group were higheRthan those in CI group(P<0.01),and significantly increased with the severity of dementia(P<0.05).Spearman correlation analysis showed that serum AGEs(R=0.446,P<0.001)and RAGE(R=0.469,P<0.001)were positively correlated with dementia severity.Multivariate Logistic regression analysis showed that education level,serum NSE,AGEs and RAGE levels were associated with the severity of dementia in the elderly CI-VD patients(P<0.05).ROC curve analysis showed that the optimal cut-off points of serum AGEs and RAGE levels foRpredicting the severity of dementia in elderly CI-VD patients were 33.07μg/mL and 550.31μg/mL,and the AUC of the combination of serum AGEs and RAGE levels was higheRthan that of AGEs oRRAGE alone(P<0.05).Conclusions Serum levels of AGEs and RAGE are related to the severity of dementia in the elderly CI-VD patients,which can be used foRpredicting the severity of dementia.