血清TSP-1、Trx1水平与脑梗死后认知功能障碍的关系

Relationship between serum TSP-1 and Trx1 levels and cognitive impairment after cerebral infarction

目的探讨血清血小板反应蛋白-1(TSP-1)、硫氧还蛋白1(Trx1)水平与脑梗死后认知功能障碍的关系。方法选取2021年6月至2022年12月该院收治的155例脑梗死患者(研究组)为研究对象,根据患者病情稳定后蒙特利尔认知评估量表(MoCA)评分分为认知功能正常组(97例)和认知功能障碍组(58例)。另选取该院同期150例体检健康者为对照组。酶联免疫吸附试验(ELISA)检测血清TSP-1和Trx1水平。Spearman分析法分析血清TSP-1和Trx1水平与脑梗死患者美国国立卫生研究院卒中量表(NIHSS)评分和MoCA评分的相关性;受试者工作特征(ROC)曲线分析血清TSP-1和Trx1水平对脑梗死后认知功能障碍的预测价值。结果与对照组比较,研究组血清TSP-1和Trx1水平明显较高,差异有统计学意义(P<0.05)。与认知功能正常组比较,认知功能障碍组血清TSP-1和Trx1水平明显较高,差异有统计学意义(P<0.05)。与认知功能正常组比较,认知功能障碍组NIHSS评分明显较高,MoCA评分明显较低,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,脑梗死患者血清TSP-1和Trx1水平与NIHSS评分呈正相关(P<0.05),与MoCA评分呈负相关(P<0.05)。ROC曲线分析结果显示,血清TSP-1水平单独预测脑梗死后认知功能障碍的曲线下面积(AUC)为0.834,灵敏度、特异度分别为72.41%、86.60%;血清Trx1水平单独预测脑梗死后认知功能障碍的AUC为0.851,其灵敏度、特异度分别为70.69%、85.57%;二者联合预测脑梗死后认知功能障碍的AUC为0.926,显著大于血清TSP-1单独预测的AUC(Z=3.050,P=0.002)和Trx1水平单独预测的AUC(Z=2.846,P=0.004)。结论血清TSP-1和Trx1水平在脑梗死患者中升高,且二者水平对脑梗死后认知功能障碍具有一定的预测价值。

Objective To investigate the relationship between serum levels of thrombospondin-1(TSP-1)and thioredoxin 1(Trx1)and cognitive impairment after cerebral infarction.Methods A total of 155 patients with cerebral infarction(study group)admitted to a hospital from June 2021 to December 2022 were selected as the study objects,and were divided into normal cognitive function group(97 cases)and cognitive impairment group(58 cases)according to the scores of the montreal cognitive assessment scale(MoCA)after the patients′condition stabilized.Another 150 healthy subjects in the same period were selected as the control group.Serum TSP-1 and Trx1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Spearman analysis was used to analyze the correlation between serum TSP-1 and Trx1 levels and national institutes of health stroke scale(NIHSS)score and MoCA score in patients with cerebral infarction.The predictive value of serum TSP-1 and Trx1 levels in cognitive impairment after cerebral infarction was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum TSP-1 and Trx1 in the study group were significantly higher,and the differences were statistically significant(P<0.05).Compared with the normal cognitive function group,the levels of serum TSP-1 and Trx1 in the cognitive impairment group were significantly higher,and the difference was statistically significant(P<0.05).Compared with the normal cognitive function group,the NIHSS score of the cognitive impairment group was significantly higher,and the MoCA score was significantly lower,with statistical significance(P<0.05).Spearman correlation analysis showed that serum TSP-1 and Trx1 levels were positively correlated with NIHSS score(P<0.05),and negatively correlated with MoCA score(P<0.05)in patients with cerebral infarction.ROC curve analysis showed that the area under the curve(AUC)of serum TSP-1 to predict cognitive impairment after cerebral infarction was 0.834,and the sensitivity and specificity were 72.41%and 86.60%,respectively.Serum Trx1 level alone predicted the AUC of cognitive impairment after cerebral infarction was 0.851,and its sensitivity and specificity were 70.69%and 85.57%,respectively.The AUC of the combined prediction of cognitive impairment after cerebral infarction was 0.926,which was significantly greater than that of serum TSP-1 alone(Z=3.050,P=0.002)and Trx1 alone(Z=2.846,P=0.004).Conclusion Serum TSP-1 and Trx1 levels are elevated in patients with cerebral infarction,and t heir levels have certain predictive value for cognitive impairment after cerebral infarction.