脑小血管病患者血清碱性磷酸酶活性与认知损害的相关性研究
|
摘要
目的:观察脑小血管病(cerebral small-vessel disease, CSVD)血管性痴呆患者及脑小血管病认知功能正常患者血清中碱性磷酸酶(alkalinephosphatase,ALP)的活性,探讨在脑小血管病中血清ALP活性与血管性痴呆的关系。方法:选择脑小血管病患者62例为研究对象,其中血管性痴呆(VD)32例诊断(血管性痴呆组),认知功能正常的脑小血管病患者30例(认知正常组)。检测两组患者的血清ALP活性。采用简易精神状态量表(MMSE)、日常生活活动能力量表(ADL)、临床痴呆评定量表(CDR)等量表进行认知功能评分,并分析血清ALP活性与认知功能评分的相关性。结果:血管性痴呆组患者血清ALP活性明显高于对照组(79.63±15.98U/L vs66.44±13.77U/L,p<0.01),血清ALP活性与MMSE评分(r=-0.452,p<0.001)、ADL评分(r=0.551,p<0.001)和CDR评分(r=0.439,p<0.001)显著相关。结论:脑小血管病血管性痴呆患者血清ALP活性明显升高,血清ALP活性与血管认知功能损害相关。血清ALP活性可作为判断脑小血管病的认知功能的参考指标。
Objective To observe the serum activity of alkaline phosphatase(ALP) incerebral small vessel disease(CSVD) patients withvascular dementia(VD) or with normal cognitive functioncontrols, and explore the correlation of serum activity of ALP and VD in patients with cerebral small vessel disease. Methods Serum samples of 32 CSVD patients with VD(VD group), and 30 age-and gender-matched CSVD patients with normal cognitive function controls(Control group) were collected in this study. We investigated the difference of serum activity of ALP between two groups, and explored the correlations of serum activity of ALP with mini-mental state examination(MMSE) scores, activities of daily living(ADL) scores and clinical dementia rating(CDR) scores. Results Serum activity of ALP was higher than that in control group(79.63±15.98 U/L vs. 66.44±13.77 U/L, p<0.01). Serum activity of ALP was significantly correlated with MMSE scores(r =-0.452, p<0.001), ADL scores(r=0.551, p<0.001), CDR scores(r=0.439, p<0.001). Conclusions Serumactivity of ALP was elevated in CSVD patients with vascular dementia. There were significantly correlations with serum activity of ALP and severity of cognitive function impairment in patients with CSVD. Serum activity of ALP maybe indicate the cognitive function in CSVD.
Objective To observe the serum activity of alkaline phosphatase(ALP) incerebral small vessel disease(CSVD) patients withvascular dementia(VD) or with normal cognitive functioncontrols, and explore the correlation of serum activity of ALP and VD in patients with cerebral small vessel disease. Methods Serum samples of 32 CSVD patients with VD(VD group), and 30 age-and gender-matched CSVD patients with normal cognitive function controls(Control group) were collected in this study. We investigated the difference of serum activity of ALP between two groups, and explored the correlations of serum activity of ALP with mini-mental state examination(MMSE) scores, activities of daily living(ADL) scores and clinical dementia rating(CDR) scores. Results Serum activity of ALP was higher than that in control group(79.63±15.98 U/L vs. 66.44±13.77 U/L, p<0.01). Serum activity of ALP was significantly correlated with MMSE scores(r =-0.452, p<0.001), ADL scores(r=0.551, p<0.001), CDR scores(r=0.439, p<0.001). Conclusions Serumactivity of ALP was elevated in CSVD patients with vascular dementia. There were significantly correlations with serum activity of ALP and severity of cognitive function impairment in patients with CSVD. Serum activity of ALP maybe indicate the cognitive function in CSVD.
引文
[1]脑小血管病诊治专家共识组.脑小血管病的诊治专家共识[J].中华内科杂志,2013,52(10):893-896.
[2]Wardlaw,J.M.;Smith,C.;Dichgans,M.Mechanisms of sporadic cerebral small vessel disease:insights from neuroimaging[J].Lancet Neurol,2013,12(5):483-97.
[3]张微微.脑小血管病的新进展[J].中华脑血管病杂志(电子版),2008,2(4):272-277.
[4]王杰;毛姗.脑小血管病引发的脑白质疏松与认知功能障碍的相关性研究[J].中国实用神经疾病杂志,2017,20(18):43-45.
[5]Grau-Olivares,M.;Arboix,A.Mild cognitive impairment in stroke patients with ischemic cerebral small-vessel disease:a forerunner of vascular dementia?[J].Expert Rev Neurother,2009,9(8):1201-17.
[6]李伟;李桂林;王拥军.脑小血管病[J].中华内科杂志,2010,49(2):163-164.
[7]Kellett,K.A.;Williams,J.;Vardy,E.R.,et al.Plasma alkaline phosphatase is elevated in Alzheimer’s disease and inversely correlates with cognitive function[J].Int JMol Epidemiol Genet,2011,2(2):114-21.
[8]Lee,H.B.;Kim,J.;Kim,S.H.,et al.Association between Serum Alkaline Phosphatase Level and Cerebral Small Vessel Disease[J].PLoS One,2015,10(11):e0143355.
[9]张兵;董瑞芳;郄新稳,等.脑梗死合并缺血性脑白质病变患者危险因素的分析[J].中华老年心脑血管病杂志,2017,19(1):67-69.
[10]Ryu,W.S.;Lee,S.H.;Kim,C.K.,et al.High serum alkaline phosphatase in relation to cerebral small vessel disease[J].Atherosclerosis,2014,232(2):313-8.
[11]Kim,J.;Song,T.J.;Song,D.,et al.Serum alkaline phosphatase and phosphate in cerebral atherosclerosis and functional outcomes after cerebral infarction[J].Stroke,2013,44(12):3547-9.
[12]Zhong,C.;You,S.;Chen,J.,et al.Serum Alkaline Phosphatase,Phosphate,and In-Hospital Mortality in Acute Ischemic Stroke Patients[J].J Stroke Cerebrovasc Dis,2018,27(1):257-266.
[13]Langer,D.;Ikehara,Y.;Takebayashi,H.,et al.The ectonucleotidases alkaline phosphatase and nucleoside triphosphate diphosphohydrolase 2 are associated with subsets of progenitor cell populations in the mouse embryonic,postnatal and adult neurogenic zones[J].Neuroscience,2007,150(4):863-79.
[14]Vardy,E.R.;Kellett,K.A.;Cocklin,S.L.,et al.Alkaline phosphatase is increased in both brain and plasma in Alzheimer's disease[J].Neurodegener Dis,2012,9(1):31-7.
[15]吴有丽;沈春子;周霞,等.皮质下缺血性血管病患者血清碱性磷酸酶变化及其对认知功能的影响[J].中华神经科杂志,2016,49(11):827-832.
[16]Alosco,M.L.;Spitznagel,M.B.;Strain,G.,et al.The effects of cystatin C and alkaline phosphatase changes on cognitive function 12-months after bariatric surgery[J].J Neurol Sci,2014,345(1-2):176-80.
[17]徐亚丽;姚莉;何小蓉,等.老年血管性痴呆患者血清C反应蛋白及白介素6检测分析[J].中国实用神经疾病杂志,2018,21(12):1334-1337.
[18]Diaz-Hernandez,M.;Gomez-Ramos,A.;Rubio,A.,et al.Tissue-nonspecific alkaline phosphatase promotes the neurotoxicity effect of extracellular tau[J].J Biol Chem,2010,285(42):32539-48.
[19]Pike,A.F.;Kramer,N.I.;Blaauboer,B.J.,et al.An alkaline phosphatase transport mechanism in the pathogenesis of Alzheimer's disease and neurodegeneration[J].Chem Biol Interact,2015,226.
[2]Wardlaw,J.M.;Smith,C.;Dichgans,M.Mechanisms of sporadic cerebral small vessel disease:insights from neuroimaging[J].Lancet Neurol,2013,12(5):483-97.
[3]张微微.脑小血管病的新进展[J].中华脑血管病杂志(电子版),2008,2(4):272-277.
[4]王杰;毛姗.脑小血管病引发的脑白质疏松与认知功能障碍的相关性研究[J].中国实用神经疾病杂志,2017,20(18):43-45.
[5]Grau-Olivares,M.;Arboix,A.Mild cognitive impairment in stroke patients with ischemic cerebral small-vessel disease:a forerunner of vascular dementia?[J].Expert Rev Neurother,2009,9(8):1201-17.
[6]李伟;李桂林;王拥军.脑小血管病[J].中华内科杂志,2010,49(2):163-164.
[7]Kellett,K.A.;Williams,J.;Vardy,E.R.,et al.Plasma alkaline phosphatase is elevated in Alzheimer’s disease and inversely correlates with cognitive function[J].Int JMol Epidemiol Genet,2011,2(2):114-21.
[8]Lee,H.B.;Kim,J.;Kim,S.H.,et al.Association between Serum Alkaline Phosphatase Level and Cerebral Small Vessel Disease[J].PLoS One,2015,10(11):e0143355.
[9]张兵;董瑞芳;郄新稳,等.脑梗死合并缺血性脑白质病变患者危险因素的分析[J].中华老年心脑血管病杂志,2017,19(1):67-69.
[10]Ryu,W.S.;Lee,S.H.;Kim,C.K.,et al.High serum alkaline phosphatase in relation to cerebral small vessel disease[J].Atherosclerosis,2014,232(2):313-8.
[11]Kim,J.;Song,T.J.;Song,D.,et al.Serum alkaline phosphatase and phosphate in cerebral atherosclerosis and functional outcomes after cerebral infarction[J].Stroke,2013,44(12):3547-9.
[12]Zhong,C.;You,S.;Chen,J.,et al.Serum Alkaline Phosphatase,Phosphate,and In-Hospital Mortality in Acute Ischemic Stroke Patients[J].J Stroke Cerebrovasc Dis,2018,27(1):257-266.
[13]Langer,D.;Ikehara,Y.;Takebayashi,H.,et al.The ectonucleotidases alkaline phosphatase and nucleoside triphosphate diphosphohydrolase 2 are associated with subsets of progenitor cell populations in the mouse embryonic,postnatal and adult neurogenic zones[J].Neuroscience,2007,150(4):863-79.
[14]Vardy,E.R.;Kellett,K.A.;Cocklin,S.L.,et al.Alkaline phosphatase is increased in both brain and plasma in Alzheimer's disease[J].Neurodegener Dis,2012,9(1):31-7.
[15]吴有丽;沈春子;周霞,等.皮质下缺血性血管病患者血清碱性磷酸酶变化及其对认知功能的影响[J].中华神经科杂志,2016,49(11):827-832.
[16]Alosco,M.L.;Spitznagel,M.B.;Strain,G.,et al.The effects of cystatin C and alkaline phosphatase changes on cognitive function 12-months after bariatric surgery[J].J Neurol Sci,2014,345(1-2):176-80.
[17]徐亚丽;姚莉;何小蓉,等.老年血管性痴呆患者血清C反应蛋白及白介素6检测分析[J].中国实用神经疾病杂志,2018,21(12):1334-1337.
[18]Diaz-Hernandez,M.;Gomez-Ramos,A.;Rubio,A.,et al.Tissue-nonspecific alkaline phosphatase promotes the neurotoxicity effect of extracellular tau[J].J Biol Chem,2010,285(42):32539-48.
[19]Pike,A.F.;Kramer,N.I.;Blaauboer,B.J.,et al.An alkaline phosphatase transport mechanism in the pathogenesis of Alzheimer's disease and neurodegeneration[J].Chem Biol Interact,2015,226.