腔隙性脑梗死患者脑白质病变情况与缺氧诱导因子1α相关性研究

Relationship between white matter lesions and hypoxia-inducing factor 1αin patients with lacunar cerebral infarction

目的:探究腔隙性脑梗死(LACI)患者脑白质病变情况与缺氧诱导因子1α(HIF-1α)的相关性。方法:收集196例LACI患者为研究对象,患者均完成MRI检查,并采用Fazekas量表评估纳入者脑白质病变情况;同时留取患者入院确诊时静脉血样,用于测定血清HIF-1α、半胱氨酸蛋白酶-3(Caspase-3);分析血清HIF-1α与脑白质病变情况的关系。结果:纳入者中72.45%出现脑白质病变,其中42.96%轻度病变,33.80%中度病变、23.24%重度病变。与非脑白质病变组相比,病变组患者年龄和高血压占比明显增大,血清HIF-1α和Caspase-3水平明显升高(均P<0.05)。脑白质不同程度病变者收缩压和血清HIF-1α和Caspase-3水平比较差异具有统计学意义(均P<0.01),重度病变者明显高于中度病变者,中度病变者高于轻度病变者(均P<0.05)。Logistic回归分析显示,收缩压和血清HIF-1α、Caspase-3水平均是影响LACI患者脑白质病变程度的危险因素(均P<0.05)。受试者工作特征(ROC)曲线分析显示,血清HIF-1α对LACI患者脑白质病变发生及重度脑白质病变均具有一定预测价值(AUC=0.840、0.874)。结论:LACI伴有脑白质病变患者体内HIF-1α呈高表达状态,且其表达水平升高与脑白质病变加重有关。

Objective:To investigate the correlation between the white matter lesions and hypoxia-inducing factor 1α(HIF-1α)in patients with lacunar cerebral infarction(LACI).Methods:A total of 196 patients with LACI were collected,all of whom underwent MRI examination,and the white matter lesions were evaluated by Fazekas scale.At the same time,the intravenous blood samples of the patients were collected at the time of admission for the determination of serum HIF-1αand Caspase-3.The relationship between serum HIF-1αand white matter lesions was analyzed.Results:72.45%of the participants had leukoencephalopathy,of which 42.96%had mild lesions,33.80%had moderate lesions and 23.24%had severe lesions.Compared with the non-leuconopathy group,the age and hypertension proportion of patients in the lesion group were significantly increased,and the serum HIF-1αand Caspase-3 levels were significantly increased(all P<0.05).There were significant differences in systolic blood pressure,serum HIF-1αand Caspase-3 levels in patients with different degrees of white matter lesions,and those with severe lesions were significantly higher than those with moderate lesions,and those with moderate lesions were significantly higher than those with mild lesions(all P<0.05).Logistic regression analysis showed that systolic blood pressure and serum HIF-1αand Caspase-3 levels were risk factors for the degree of leuconopathy in LACI patients(all P<0.05).ROC curve analysis showed that serum HIF-1αhad a certain predictive value in the occurrence and severity of leukodystrophy in LACI patients(AUC=0.840,0.874).Conclusion:HIF-1αis highly expressed in LACI patients with leukodystrophy,and the increase of HIF-1αexpression is related to the aggravation of leukodystrophy.