Tissue engineering of blood vessels with endothelial cells differentiated from mouse embryonic stem cells

Endothelial cells (TEC_3 cells) derived from mouse embryonic stem (ES) cells were used as seed cells to construct blood vessels. Tissue engineered blood vessels were made by seeding 8 × 10~6 smooth muscle cells (SMCs) obtained from rabbit arteries onto a sheet of nonwoven polyglycolic acid (PGA) fibers, which was used as a biodegradable polymer scaffold. After being cultured in DMEM medium for 7 days in vitro, SMCs grew well on the PGA fibers, and the cell-PGA sheet was then wrapped around a silicon tube, and implanted subcutaneously into nude mice. After 6～8 weeks, the silicon tube was replaced with another silicon tube in smaller diameter, and then the TEC_3 cells (endothelial cells differentiated from mouse ES cells) were injected inside the engineered vessel tube as the test group. In the control group only culture medium was injected. Five days later, the engineered vessels were harvested for gross observation, histological and immunohistochemical analysis. The preliminary results demonstrated that the SMC-PGA construct could form a tubular structure in 6～8 weeks and PGA fibers were completely degraded. Histological and immunohistochemical analysis of the newly formed tissue revealed a typical blood vessel structure, including a lining of endothelial cells (ECs) on the lumimal surface and the presence of SMC and collagen in the wall. No EC lining was found in the tubes of control group. Therefore, the ECs differentiated from mouse ES cells can serve as seed cells for endothelium lining in tissue engineered blood vessels.

Electro-acupuncture at Conception and Governor vessels and transplantation of umbilical cord bloodderived mesenchymal stem cells for treating cerebral ischemia/reperfusion injury

Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels also has positive effects as a treatment for cerebral ischemia/ reperfusion. Therefore, we hypothesized that electro-acupuncture at Conception and Governor vessels plus mesenchymal stem cell transplantation may have better therapeutic effects on the promotion of angiogenesis and recovery of neurological function than either treatment alone. In the present study, human umbilical cord blood-derived mesenchymal stem cells were isolated, cultured, identified and intracranially transplanted into the striatum and subcortex of rats at 24 hours following cerebral ischemia/reperfusion. Subsequently, rats were electro-acupunctured at Conception and Governor vessels at 24 hours after transplantation. Modified neurological severity scores and immunohistochemistry findings revealed that the combined interventions of electro-acupuncture and mesenchymal stem cell transplantation clearly improved neurological impairment and up-regulated vascular endothelial growth factor expression around the isch- emic focus. The combined intervention provided a better outcome than mesenchymal stem cell transplantation alone. These findings demonstrate that electro-acupuncture at Conception and Governor vessels and mesenchymal stem cell transplantation have synergetic effects on promot- ing neurological function recovery and angiogenesis in rats after cerebral ischemia/reperfusion.

Advances in the differentiation of pluripotent stem cells into vascular cells

Blood vessels constitute a closed pipe system distributed throughout the body,transporting blood from the heart to other organs and delivering metabolic waste products back to the lungs and kidneys.Changes in blood vessels are related to many disorders like stroke,myocardial infarction,aneurysm,and diabetes,which are important causes of death worldwide.Translational research for new appro-aches to disease modeling and effective treatment is needed due to the huge socio-economic burden on healthcare systems.Although mice or rats have been widely used,applying data from animal studies to human-specific vascular physiology and pathology is difficult.The rise of induced pluripotent stem cells(iPSCs)provides a reliable in vitro resource for disease modeling,regenerative medicine,and drug discovery because they carry all human genetic information and have the ability to directionally differentiate into any type of human cells.This review summarizes the latest progress from the establishment of iPSCs,the strategies for differentiating iPSCs into vascular cells,and the in vivo trans-plantation of these vascular derivatives.It also introduces the application of these technologies in disease modeling,drug screening,and regenerative medicine.Additionally,the application of high-tech tools,such as omics analysis and high-throughput sequencing,in this field is reviewed.

Endothelial cells and blood vessels are major targets for COVID-19-induced tissue injury and spreading to various organs

The coronavirus disease 2019(COVID-19)infected so far over 250 million people and caused the death of over 5 million worldwide.Aging,diabetes,and cardiovascular diseases,conditions with preexisting impaired endothelial functions predispose to COVID-19.While respiratory epithelium is the main route of virus entry,the endothelial cells(ECs)lining pulmonary blood vessels are also an integral part of lung injury in COVID-19 patients.COVID-19 not only affects the lungs and respiratory system but also gastrointestinal(GI)tract,liver,pancreas,kidneys,heart,brain,and skin.Blood vessels are likely conduits for the virus dissemination to these distant organs.Importantly,ECs are also critical for vascular regeneration during injury/lesions healing and restoration of vascular network.The World Journal of Gastroenterology has published in last two years over 67 outstanding papers on COVID-19 infection with a focus on the GI tract,liver,pancreas,etc.,however,the role of the endothelial and vascular components as major targets for COVID-19-induced tissue injury,spreading to various organs,and injury healing have not been sufficiently emphasized.In the present article,we focus on these subjects and on current treatments including the most recent oral drugs molnupiravir and paxlovid that show a dramatic,significant efficacy in controlling severe COVID-19 infection.

Determinants of PHGPx Expression in a Cultured Endothelial Cell Line

Selenoprotein biosynthesis may not only be affected by the availability of selenium and the transcription rate of pertinent genes but also by the activity of components of the selenocysteine incorporation complex, SelA, B, C, or D. Incorporation of selenocysteine into selenoproteins requires a complex co-translational mechanism guaranteeing the correct recoding of the termination codon TGA as selenocysteine codon. A particular tRNASer(Sec) is enzyrnatically transformed by selenophosphate into tRNAsec which recognizes the UGA codon by means of a specific elongation factor (SelB) and a peculiar mRNA secondary structure. Selenophosphate is formed from selenide and ATP by the SelD gene product, selenophosphate synthase (SelD). To further elucidate the biological role of phospholipid hydroperoxide GPx (PHGPx), we transformed cells with a heterologous (pig) PHGPx gene and/or an additional (human) SelD gene and studied the behaviour of these cells under selenium depletion and repletion. Transfection of the endothelial cell line ECV 304 with either PHGPx cDNA or SelD cDNA did not result in a substantial increase of PHGPx activities, independent of selenium supply. However, cells co-trans fected with both, PHGPx and SelD cDNA, expressed significantly higher PHGPx activlty. This effect was much more pronounced under selenium limiting conditions. The enhanced PHGPx activity correlated with two functional pararneters, increased capability to reduce hydroperoxides and less sensitivity against H2O2-induced cytotoxicity. Thus, the ECV cells, stably transfected with PHGPx and SelD cDNA, provide a model to specifically investigate the role of PHGPx in endothelial cell function

Regulation Effect of Vascular Endothelial Growth Factor on Human Fetal Choroid Vascularization

Purpose:To investigate the spatial and temporal regulation effect of vascular endothelial growth factor(VEGF)on human fetal choroid vascularization.Methods:The eyeballs of 54human fetuses from the 9th week to the40th week due to accidental abortion were studied by immunohistochemically staining for the expression of VEGF and proliferation cell nuclear antigen(PCNA).Results:(1)The distribution of VEGF expression in the retinal pigment epithelium(RPE)decreased with the increase of age,the peak of which was between the 9th and 14th week,(2)PCNAimmunoreactivity was localized within choriocapillaris endothe-lium,THe expression level decreased alone with fetus age,In this period the chori-ocapillaris endothelium kept proliferation,differentiation.canalization and remodelled to form the choroid vessels.(3)Statistically significant correlations were shown between the expression of VEGF in the PRE and that of PCNAin choriocapillaris endothelium(r=0.933,P<0.01).Conclusion:VEGF expression in PRE was positively involved in modulating human fetal choroid vascularization.Eye Science2000;16:11-14.

Regulation effect of vascular endothelial growth factor on vascularization and angiogenesis in developmental human fetal retinas

目的 :研究血管内皮生长因子 ( Vascular endothelial growth factor VEGF)对人胚胎视网膜血管发生的调节作用。方法 :收集 54例 9～ 4 0周龄胎儿眼球后壁标本 ,免疫组织化学染色 ,光镜观察。结果 :1VEGF在视网膜的表达呈波峰式分布 ,高峰在 9～ 13周及 2 6周左右。 2节细胞层的梭形细胞(血管内皮细胞前体细胞 )、血管内皮细胞呈增殖细胞核抗原 ( Proliferation cell nucelear antigen,PCNA)免疫反应阳性 ,水平波动 ,高峰在 9～ 13周及 2 1周前后 ,此期间梭形细胞不断增殖、分化形成内皮细胞索 ,经改建形成视网膜内层血管 ,2 6、34周起见内核层内、外缘血管内皮细胞呈 PCNA免疫反应阳性 ,并保持至足月。 3视网膜 VEGF表达量与梭形细胞、血管内皮细胞 PCNA表达量呈显著正相关( r=0 .736,P<0 .0 1)。结论

川芎嗪对缺氧缺糖状态下培养的血管内皮细胞ECV-304的影响

目的 :观察缺氧缺糖条件下血管内皮细胞 (ECV 30 4 )释放乳酸脱氢酶 (LDH)、一氧化氮 (NO)、丙二醛(MDA)水平和细胞膜流动性的变化及川芎嗪对它们的影响。方法 :缺氧缺糖诱导血管内皮细胞损伤 ,自动生化分析仪测定培养液和细胞层中LDH活性 ;用比色法测定细胞培养液中NO水平 ;用荧光法检测细胞内脂质过氧化产物MDA以评价脂质过氧化程度 ;荧光偏振法测定内皮细胞膜流动性。结果 :缺氧缺糖引起的血管内皮细胞LDH释放增加、MDA生成增多和膜流动性增高 ,NO水平降低。而川芎嗪可抑制缺氧缺糖引起的血管内皮细胞释放LDH ,MDA生成和降低细胞膜流动性 ,提高NO水平。结论 :川芎嗪可保护缺氧缺糖诱导血管内皮细胞的损伤 ,其作用机制有待进一步研究。

干细胞在小口径人工血管内皮化中的应用

背景:小口径人工血管移植后由于血栓形成和内膜增生等原因造成管腔狭窄甚至闭塞,运用干细胞作为种子细胞实现人工血管的内皮化有助于改善血管移植后的远期通畅率。目的:总结干细胞在小口径人工血管内皮化中应用的研究进展。方法:由第一作者检索Pub Med和万方数据库2013-2023年发表的相关文献,英文检索词为“vascular graft,tissue-engineered blood vessel/vascular tissue engineering,endothelialization,stem cells,endothelial progenitor cells,mesenchymal stem cells,induced pluripotent stem cells,embryonicstemcells”,中文检索词为“人工血管,组织工程血管/血管组织工程,内皮化,干细胞,内皮祖细胞,间充质干细胞,诱导多能干细胞,胚胎干细胞”,检索近10年国内外关于干细胞应用于小口径人工血管内皮化的相关文献,初检文献552篇,根据纳排标准最终选取81篇文献进行综述。结果与结论:(1)远期通畅率不理想限制了小口径人工血管的临床应用,造成远期通畅率低下的主要原因是血栓形成和内膜增生。天然血管内皮层具有良好的抗血栓及内膜增生性能,内皮化可以模拟天然血管的特性,是提升远期通畅率的有效手段。(2)小口径人工血管植入体内后会经历体内内皮化过程,但难以形成完整的内皮层。干细胞具有分化为内皮细胞的潜能,体内招募干细胞或将其作为种子细胞种植在人工血管内表面是实现内皮化的研究策略。(3)将内皮祖细胞、间充质干细胞、诱导多能干细胞及胚胎干细胞等作为种子细胞种植均能够一定程度改善小口径人工血管的远期通畅率,且它们各具优势。内皮祖细胞便于获取且可直接用于种植;间充质干细胞来源广泛且具有旁分泌和调节免疫的功能;诱导多能干细胞来源丰富且可消除免疫原性;胚胎干细胞增殖能力强且能多向分化。(4)将干细胞用于人工血管的研究目前仍未转化至临床,未来需要进一步研究并促进临床转化。

血管抑制素对血管内皮细胞系ECV-304的抑制作用

目的 观察血管抑制素 (Angiostatin)对血管内皮细胞系ECV 3 0 4的抑制作用。 方法 利用MTT法分析结果 ,实验分为 :1 .将血管抑制素与细胞同时加入 ;2 .先接种细胞 ,培养 2 4h后再加血管抑制素。结果 血管抑制素对ECV 3 0 4的抑制作用呈典型的量效关系。结论 血管抑制素对血管内皮细胞有显著的抑制作用。

神经纤毛因子1在骨折愈合中促进骨-血管偶联的作用

背景:神经纤毛因子1在骨折愈合过程中发挥重要作用,尤其是在促进骨-血管偶联方面。骨-血管偶联是骨折愈合过程中的关键事件之一,包括血管(尤其是H型血管)、新骨形成以及它们之间的关联。目的:回顾神经纤毛因子1在骨折愈合过程中促骨-血管偶联作用的研究进展。方法:在中国知网、PubMed数据库检索1982年1月至2024年4月发表的文献,以“Neuropilin-1,neuropilin 1,NRP1,neuropilin-1,NRP-1,Neuropilin 1,Nrp1,Nrp-1”为检索词,从中选择与骨折愈合、H型血管、动脉、骨细胞、骨-血管偶联关系紧密的文献43篇,增加手工检索的文献24篇,最终得到67篇文献。结果与结论:(1)在骨折愈合过程中骨-血管偶联的关键事件包括血管生成、新骨形成以及它们之间的关联,其中H型血管生成是骨折愈合过程中的关键事件之一,H型血管由血管内皮细胞以及周细胞组成;新骨形成主要是由成骨细胞、破骨细胞以及软骨细胞等骨细胞共同完成的;(2)神经纤毛因子1可以通过血管内皮生长因子和血小板衍生生长因子促进内皮细胞迁移、稳定,增强周细胞稳定性及其与内皮细胞之间的关联,从而促进血管再生;(3)神经纤毛因子1通过促进成骨细胞和软骨细胞形成、抑制破骨细胞生成来促进骨再生;(4)神经纤毛因子1可能是血管和骨偶联的关键因子之一;(5)局部应用神经纤毛因子1及其生物制剂,或将神经纤毛因子1、纳米载药系统以及高分子智能聚合材料等生物工程材料融合,为骨折治疗提供了新思路,有着广阔的应用前景。

The importance of laminin at the blood-brain barrier

The blood-brain barrier is a unique property of central nervous system blood vessels that protects sensitive central nervous system cells from potentially harmful blood components.The mechanistic basis of this barrier is found at multiple levels,including the adherens and tight junction proteins that tightly bind adjacent endothelial cells and the influence of neighboring pericytes,microglia,and astrocyte endfeet.In addition,extracellular matrix components of the vascular basement membrane play a critical role in establishing and maintaining blood-brain barrier integrity,not only by providing an adhesive substrate for blood-brain barrier cells to adhere to,but also by providing guidance cues that strongly influence vascular cell behavior.The extracellular matrix protein laminin is one of the most abundant components of the basement membrane,and several lines of evidence suggest that it plays a key role in directing blood-brain barrier behavior.In this review,we describe the basic structure of laminin and its receptors,the expression patterns of these molecules in central nervous system blood vessels and how they are altered in disease states,and most importantly,how genetic deletion of different laminin isoforms or their receptors reveals the contribution of these molecules to blood-brain barrier function and integrity.Finally,we discuss some of the important unanswered questions in the field and provide a“to-do”list of some of the critical outstanding experiments.

Topographic patterns of vascular disease: HOX proteins as determining factors?

Steadily increasing evidence supports the idea that genetic diversities in the vascular bed are, in addition to hemodynamic influences, a major contributing factor in determining region-specific cardiovascular disease susceptibility. Members of the phylogenetically highly conserved Hox gene family of developmental regulators have to be viewed as prime candidates for determining these regional genetic differences in the vasculature. During embryonic patterning, the regionally distinct and precisely choreographed expression patterns of HOX transcription factors are essential for the correct specification of positional identities. Apparently, these topographic patterns are to some degree retained in certain adult tissues, including the circulatory system. While an understanding of the functional significance of these localized Hox activities in adult blood vessels is only beginning to emerge, an argument can be made for a role of Hox genes in the maintenance of vessel wall homeostasis and functional integrity on the one hand, and in regulating the development and progression of regionally restricted vascular pathologies, on the other. Initial functional studies in animal models, as well as data from clinical studies provide some level of support for this view. The data suggest that putative genetic regulatory networks of Hox-dependent cardiovascular disease processes include genes of diverse functional categories(extracellular matrix remodeling, transmembrane signaling, cell cycle control, inflammatory response, transcriptional control, etc.), as potential targets in both vascular smooth muscle and endothelial cells, as well as cell populations residing in the adventitia.

In situ hybridization of neuropeptide Y gene expression in the endothelial cells of human umbilical blood vessels

In recent years, the endothelial cell has become the popular subject of many scientificresearch fields such as cardiovascular and cancer pathology. The results reported up to nowindicate that the endothelial cell has the complex funtion in synthesis and metabolism, andtherefore plays an important role in the regulation of vascular function. Burnstock’s labfirst observed that many kinds of vasoactive substances are localized in the endothelial

内皮细胞Piezo1调控H型血管生成在骨质疏松症病理机制中的意义

内皮细胞(endothelial cells,ECs)缺失Piezo1不仅能影响骨重塑导致骨量丢失、加重骨质疏松症,而且能引起H型血管的减少;H型血管调控的成骨-成血管偶联失衡在骨质疏松症的发病过程中起到关键作用。Piezo1为治疗骨质疏松症提供了分子层面的新思路和新视角。笔者主要对Piezo1蛋白介导的H型血管生成的机制作一综述,总结近年来关于骨质疏松症及内皮细胞Piezo1的最新研究进展,为骨质疏松症的治疗提供新的临床见解和理论依据。

通过整合的生物信息学方法鉴定H和L型血管内皮细胞中的ceRNA网络

目的:H型血管是一种骨特异性微血管亚型(CD31hiEmcnhi),在成血管-成骨耦联机制中具有重要的调节作用。研究报道H和L型血管在骨骼生理和病理条件下发挥不同的作用,它们之间的遗传差异仍有待阐明。本研究旨在通过整合的生物信息学方法构建H和L型血管内皮细胞中关键差异表达(differential expression,DE)基因的竞争性内源RNA(competitive endogenous RNA,ceRNA)网络。方法:从ArrayExpress和基因表达综合(Gene Expression Omnibus,GEO)数据库中下载相关原始数据,通过Limma R-Bioconductor包筛选H和L型血管间的DE lncRNAs、DE miRNAs和DE mRNAs,构建总ceRNA网络,随后根据蛋白质相互作用(protein-protein interaction,PPI)网络筛选出上调和下调的关键基因,以此精细化ceRNA网络并对关键基因进行富集分析。最后,通过流式细胞术和real time RT-PCR进行随机验证。结果:共鉴定出1 761个DE mRNAs、187个DE lncRNAs和159个DE miRNAs,通过相互作用关系构建总ceRNA网络;通过PPI网络筛选出6个上调(Itga5、Kdr、Tjp1、Pecam1、Cdh5、Ptk2)和2个下调(Csf1r、Il10)的关键基因,并以此构建关键基因相关的ceRNA亚网络。上调的关键基因主要富集在血管生成与血管凋亡的负调控;流式细胞术和real-time RT-PCR的结果与生物信息学分析结果一致。结论:本研究根据所筛选的关键基因提出上调和下调的H型和L型血管内皮细胞相关的ceRNA网络,为H型和L型血管内皮细胞在骨代谢中的调控机制提供了新见解。

巨噬细胞对动脉壁淋巴管生成的调节作用

巨噬细胞在动脉粥样硬化中发挥多重作用。动脉粥样硬化的进展与病变部位动脉的淋巴管的形态和功能改变有关,但其机制尚不完全清楚。文章主要对动脉粥样硬化中巨噬细胞的来源、分型、标志物及对动脉粥样硬化的功能作用,淋巴管的起源、结构功能及标志物,动脉粥样硬化病变不同时期动脉壁淋巴管生成的变化,淋巴管生成在动脉粥样硬化中的功能作用,巨噬细胞的淋巴管迁移及其参与淋巴管新生的作用机制进行综述,以期为动脉粥样硬化的机制研究和临床治疗提供依据。

LYVE1+巨噬细胞在RA患者关节滑膜组织中表达变化及对RA-FLS细胞迁移、侵袭、FMT的抑制作用

目的观察淋巴管内皮受体-1(LYVE1)+巨噬细胞在类风湿性关节炎(RA)患者关节滑膜组织中的表达变化及对RA成纤维样滑膜细胞(RA-FLS)迁移、侵袭、向肌成纤维细胞转化(FMT)的抑制作用。方法采用免疫荧光染色法对45例RA患者及45例骨关节炎(OA)患者滑膜组织LYVE1、CD68进行定性、定量检测。取对数生长期人单核白血病细胞THP-1,在培养液中加入LYVE1过表达慢病毒,培养48 h获得表达LYVE1的THP-1细胞,在表达LYVE1的THP-1细胞中加入100 ng/mL的佛波酯(PMA)诱导培养48 h,获得LYVE1+巨噬细胞;另取部分THP-1细胞,仅加入100 ng/mL的PMA诱导培养48 h获得LYVE1-巨噬细胞。取对数生长期人类风湿性关节炎成纤维细胞MH7A分为LYVE1+巨噬细胞组、LYVE1-巨噬细胞组,分别加入LYVE1+巨噬细胞、LYVE1-巨噬细胞,另将仅含培养基的小室设为空白对照组,采用划痕实验观察各组细胞的迁移能力。取MH7A细胞分为A组、B组,分别加入LYVE1+巨噬细胞、LYVE1-巨噬细胞,将仅含培养基小室设为C组,采用Transwell侵袭实验观察各组细胞的侵袭能力。取MH7A细胞分为一组、二组,分别加入LYVE1+巨噬细胞、LYVE1-巨噬细胞,将仅含培养基小室设为空白组,培养48 h时采用实时定量PCR法检测各组MH7A细胞FMT相关基因(COL1A1、fibronectin、α-SMA)的mRNA。结果RA与OA患者滑膜组织中LYVE1、CD68表达位置基本重叠;RA与OA患者滑膜组织LYVE1相对表达量分别为0.319±0.033、1.000±0.159,二者比较,P<0.05。与LYVE1-巨噬细胞组、空白对照组比较,培养24、48 h时LYVE1+巨噬细胞组细胞划痕愈合比低(P均<0.05);与B组、C组比较,培养24 h时A组细胞穿膜细胞数少(P均<0.05);与二组、空白组比较,培养48 h时一组细胞COL1A1 mRNA、fibronectin mRNA、α-SMA mRNA相对表达量少(P均<0.05)。结论RA患者关节滑膜组织中LYVE1+巨噬细胞低表达。LYVE1+巨噬细胞可抑制RA-FLS的迁移、侵袭及FMT。

具有内表面拓扑结构的仿生血管设计与制备

针对临床人工血管不具备诱导内皮化的内表面微结构,无法为内皮细胞生长提供合适的力学环境的问题,设计并制备了一种具有内表面拓扑结构的仿生血管(BVST),实现了壁面剪切力的优化分布。基于内皮细胞的形态分布,设计了具有正交、菱形、圆弧三种内表面拓扑结构的仿生血管。通过仿真分析,发现正交与菱形结构的BVST对血液流速影响较小,周期波动相近,且BVST的内表面拓扑结构能减缓细胞流速、增加细胞滞留时间,有利于内皮细胞在进行体外培养时沉积、黏附在BVST内表面。通过对比BVST与无拓扑结构仿生血管的剪切力分布,发现BVST整体剪切力分布更加均匀。分析单个拓扑单元内的剪切力分布,发现菱形拓扑单元内部剪切力分布均匀且连续,剪切力变化较小,有利于内皮细胞的生长。将聚己内酯(PCL)溶于二氯甲烷(DCM)配制质量分数35%的PCL-DCM溶液,采用内径为0.2 mm的针头,在移动速度40 mm/s、电压5.8 kV、针头高度1 mm、挤出气压0.05 MPa的条件下,基于电纺直写技术制备具有拓扑结构的仿生血管内膜;将拓扑结构浸水黏附在纺丝收集柱,基于静电纺丝技术制备仿生血管外膜,获得具有内表面拓扑结构的双层仿生血管。提出的仿生血管设计与制备工艺可为血管内皮化研究提供参考。

血清CXCL16、ESM-1水平对脑小血管病患者认知障碍的诊断价值

目的探讨血清CXC趋化因子配体16(CXCL16)、内皮细胞特异性分子1(ESM-1)水平对脑小血管病(CSVD)患者认知障碍的诊断价值。方法选取2019年10月至2022年10月期间我院收治的131例CSVD患者,根据患者入院时的蒙特利尔认知评估量表(MoCA)评分结果,将CSVD患者分为认知正常组(60例)和认知障碍组(71例)。Spearman法分析血清CXCL16、ESM-1表达水平与MoCA评分的相关性,Logistic回归分析影响CSVD患者发生认知障碍的相关因素,受试者工作特征(ROC)曲线分析血清CXCL16和ESM-1对CSVD患者认知障碍的诊断价值。结果认知障碍组患者血清CXCL16表达水平高于认知正常组,血清ESM-1表达水平低于认知正常组(P<0.05);血清CXCL16表达水平与MoCA评分呈负相关(r=-0.767,P<0.05),血清ESM-1表达水平与MoCA评分呈正相关(r=0.723,P<0.05);认知障碍组年龄≥60岁、有高血压史、脑梗死的患者所占比例高于认知正常组(P<0.05);年龄、高血压史、脑梗死及CXCL16为CSVD患者发生认知障碍的危险因素,ESM-1为保护因素(P<0.05);血清CXCL16、ESM-1以及二者联合诊断CSVD患者发生认知障碍的AUC分别为0.748、0.671、0.851,二者联合检测优于血清CXCL16、ESM-1各自单独检测(Z二者联合-CXCL16=3.284、Z二者联合-ESM-1=4.111,P=0.001、<0.001),对CSVD并发认知障碍具有较高的诊断价值。结论血清CXCL16、ESM-1的表达水平与CSVD并发认知障碍的发生密切相关,二者联合对CSVD并发认知障碍具有较高的诊断价值。