脑血管病患者血清PTGS2,CHI3L1表达水平及与认知功能障碍的相关研究

Expression Levels of Serum PTGS2 and CHI3L1 in Patients with Cerebrovascular Disease and Their Correlation with Cognitive Impairment

目的研究血清前列腺素内过氧化物合酶2(prostaglandin-endoperoxide synthase 2,PTGS2)和几丁质酶-3样蛋白1(chitinase-3-like protein 1,CHI3L1)水平与脑血管病所致认知功能障碍的相关性。方法选取2020年10月~2022年10月成都市第三人民医院收治的96例脑血管病住院患者为研究对象。记录患者基本临床资料,酶联免疫吸附法(ELISA)检测血清PTGS2和CHI3L1水平,患者依据有无认知功能障碍分为正常组(n=60)和障碍组(n=36);血清PTGS2和CHI3L1水平与空腹血糖(fasting blood glucose,FBG)、同型半胱氨酸(homocysteine,Hcy)的相关性采用Pearson法分析;Logistic回归模型判断血清PTGS2和CHI3L1是否可作为预测认知功能障碍的独立危险因素;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,根据曲线下面积(area under the curve,AUC)分析血清PTGS2和CHI3L1表达水平对脑血管病患者认知功能障碍的预测价值。结果与正常组比较,障碍组血清PTGS2(29.30±9.46 pg/ml vs 17.86±5.40 pg/ml),CHI3L1(13.04±4.06 pg/ml vs 7.51±2.66 pg/ml)水平均升高,差异有统计学意义(t=7.553,8.065,均P<0.05);多因素Logistic回归分析结果显示,FBG(OR=3.612,95%CI:2.324~5.614),Hcy(OR=2.584,95%CI:1.351~4.944),PTGS2(OR=1.964,95%CI:1.194~3.231)和CHI3L1(OR=1.556,95%CI:1.023~2.367)是认知功能障碍的独立危险因素(均P<0.05);PTGS2与FBG,Hcy呈正相关(r=0.368,0.551,均P<0.05),CHI3L1与FBG,Hcy呈正相关(r=0.510,0.376,均P<0.05)。ROC曲线显示,PTGS2预测认知功能障碍的AUC为0.819,CHI3L1预测认知功能障碍的AUC为0.829,二者联合预测认知功能障碍的AUC为0.902,高于二者单独预测(Z=2.089,2.293;P=0.037,0.021),其敏感度和特异度分别为77.78%,98.33%。结论PTGS2和CHI3L1在脑血管病认知功能障碍患者血清中高表达,二者均与脑血管病患者认知功能障碍有关。

Objective To investigate the correlation between serum levels of prostaglandin-endoperoxide synthase 2(PTGS2),chitinase-3-like protein 1(CHI3L1)and cognitive impairment caused by cerebrovascular disease.Methods From October 2020 to October 2022,96 inpatients with cerebrovascular diseases admitted to the Third People’s Hospital of Chengdu were regarded as the study subjects.The basic clinical data of the patients were recorded,the serum levels of PTGS2 and CHI3L1 were detected by enzyme-linked immunosorbent assay,and these patients were grouped into normal group(n=60)and impaired group(n=36)based on the presence or absence of cognitive impairment.The correlation between serum PTGS2 and CHI3L1 levels and fasting blood glucose(FBG)and homocysteine(Hcy)was analyzed by Pearson method.Logistic regression model was used to determine whether serum PTGS2 and CHI3L1 were independent risk factors for predicting cognitive impairment.Receiver operating characteristic(ROC)curve was drawn,and the predictive value of CHI3L1 and serum PTGS2 expression level in cognitive impairment in patients with cerebrovascular disease was analyzed according to the area under the curve(AUC).Results Compared with the normal group,the levels of serum PTGS2(29.30±9.46 pg/ml vs 17.86±5.40 pg/ml)and CHI3L1(13.04±4.06 pg/ml vs 7.51±2.66 pg/ml)in the disorder group were increased,and the differences were statistically significant(t=7.553,8.065,all P<0.05).Multivariate Logistic regression analysis showed that FBG(OR=3.612,95%CI:2.324~5.614),Hcy(OR=2.584,95%CI:1.351~4.944),PTGS2(OR=1.964,95%CI:1.194~3.231)and CHI3L1(OR=1.556,95%CI:1.023~2.367)were independent risk factors of cognitive impairment(all P<0.05).PTGS2 was positively correlated with FBG and Hcy(r=0.368,0.551,all P<0.05),and CHI3L1 was positively correlated with FBG and Hcy(r=0.510,0.376,all P<0.05).The ROC curve showed that the area under curve(AUC)of PTGS2 and CHI3L1 in predicting cognitive impairment was 0.819 and 0.829,respectively.The AUC of the combined prediction of cognitive impairment was 0.902,which was obviously higher than that of the independent prediction of the two(Z=2.089,2.293;P=0.037,0.021),with sensitivity and specificity of 77.78%and 98.33%,respectively.Conclusion PTGS2 and CHI3L1 were highly expressed in the serum of patients with cognitive impairment of cerebrovascular disease,indicating that both were related to cognitive impairment of patients with cerebrovascular disease.