TTR CLU IL-6与脑卒中后继发认知功能障碍的相关性及预后预测价值

Correlation between TTR,CLU,IL-6 and secondary cognitive dysfunction after stroke and its prognostic value

目的探讨人转运甲状腺素蛋白(transthyretin,TTR)、人凝聚素(human clusterin,CLU)、白细胞介素-6(interleukin-6,IL-6)与脑卒中后继发认知功能障碍的相关性及预后预测价值。方法选取高邮市中医医院收治的500例脑卒中患者,根据简易智能精神状态检查量表(mini-mental state examination,MMSE)得分,分为认知功能障碍组180例和非认知功能障碍组320例,另选取200名健康志愿者作为对照组,对比3组受检者TTR、CLU、IL-6表达水平,并分析与脑卒中后继发认知功能障碍的相关性。随访患者预后情况,根据180例脑卒中后继发认知功能障碍患者治疗后的MMSE得分分为预后良好组110例和预后不良组70例,对比2组患者临床一般情况与TTR、CLU、IL-6表达水平,并用Logistic回归分析分析这些指标对卒中后继发认知功能障碍的预后预测价值。结果认知功能障碍组TTR、IL-6高于非认知功能障碍组和对照组,CLU低于非认知功能障碍组和对照组(P<0.05);Spearman相关分析结果显示,TTR、IL-6与脑卒中后继发认知功能障碍呈正相关,与CLU呈负相关(P>0.05);预后良好组与预后不良组患者体质量指数,是否首发,TTR、CLU、IL-6水平对比差异有统计学意义(P<0.05);Logistic回归分析显示,TTR、CLU、IL-6为脑卒中后继发认知功能障碍的预后独立影响因素(P<0.05)。结论血清TTR、CLU、IL-6水平不仅与脑卒中后继发认知功能障碍具有明显相关性,还为其预后独立影响因素。因此,临床上可考虑将TTR、CLU、IL-6三者作为脑卒中后认知功能障碍的诊断及预后预测指标。

Objective To investigate the correlation and prognostic value of human TTR,CLU,IL-6 with cognitive dysfunction after stroke.Methods 500 stroke patients admitted to our hospital were selected,and were evaluated with the MMSE,and were divided into cognitive impairment group(n=180)and non cognitive impairment group(n=320),and 200 healthy volunteers were selected as the control group.The expression level of TTR,CLU IL-6 and the correlation between TTR,CLU,IL-6 and secondary cognitive dysfunction after stroke were analyzed.Follow up the prognosis of all patients.Based on the MMSE scores of 180 patients after treatment,patients were divided into a good(n=110)and poor prognosis group(n=70).The clinical general situation of the two groups and the expression level of TTR,CLU,IL-6 were compared,and prognostic value of TTR,CLU IL-6 in secondary cognitive dysfunction after stroke.Results TTR,IL-6 in cognitive impairment group were higher than those in non cognitive impairment group and control group,while CLU was lower(P<0.05).Spearman correlation analysis showed that TTR and IL-6 were positively correlated with secondary cognitive dysfunction after stroke,and negatively correlated with CLU(P>0.05).There was significant difference in BMI,first episode,TTR,CLU and IL-6 levels between the good and poor prognosis groups(P<0.05).Logistic regression analysis showed that TTR,CLU and IL-6 were independent prognostic factors of secondary cognitive impairment after stroke(P<0.05).Conclusion The levels of serum TTR,CLU and IL-6 are not only significantly correlated with the secondary cognitive dysfunction after stroke,but also independent prognostic factors.Therefore,TTR,CLU and IL-6 can be considered clinically as the diagnostic and prognostic indicators of cognitive dysfunction after stroke.