脑梗死患者高半胱氨酸与类胰岛素样生长因子-1的表达水平及与认知功能的相关性分析
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摘要
目的探讨脑梗死患者高半胱氨酸(t Hcy)与类胰岛素样生长因子-1(IGF-1)的表达水平及与认知功能的相关性。方法我院收治的93例脑梗死患者(脑梗死组)及同期46例健康体检者(非脑梗死组),比较两组t Hcy、IGF-1表达水平,根据脑梗死患者认知功能分为认知功能障碍组与认知功能正常组,比较两组t Hcy、IGF-1表达水平,分析影响脑梗死患者产生认知功能障碍相关危险因素。结果脑梗死组t Hcy浓度高于非脑梗死组,IGF-1浓度及MoCA评分均低于非脑梗死组(P <0. 05)。52例(55. 91%)出现认知功能障碍,41例(44. 08%)认知功能正常。年龄>60岁、t Hcy≥15. 4μmol/L、IGF-1 <140. 3ng/ml、SBP≥140 mm Hg、DBP≥90 mm Hg是影响脑梗死患者发生认知功能障碍的独立危险因素(P <0. 05)。结论血清IGF-1与t Hcy浓度是影响脑梗死患者发生认知功能障碍的独立危险因素,IGF-1 <140. 3 ng/ml或t Hcy≥15. 4μmol/L者发生脑梗死患者发生认知功能障碍的风险较大。
Objective To analyze the expression levels of homocysteine( t Hcy) and insulin-like growth factor 1( IGF-1) in patients with cerebral infarction and their correlation with cognitive function.Methods The clinical data of 93 patients with cerebral infarction and 46 healthy patients who were treated in our hospital were retrospectively analyzed.The patients were divided into cerebral infarction and non-cerebral infarction group.The expression levels of t Hcy and IGF-1 were compared between the two groups.Based on cognitive function,the patients were divided into cognitive dysfunction group and normal cognitive group.The expression levels of t Hcy and IGF-1 level were compared the two groups.The influence factors related to cognitive dysfunction in the patients were analyzed.Results The t Hcy concentrations of the cerebral infarction group was significantly higher than that of the non-cerebral infarction group,and the IGF-1 concentration and MoCA score were significantly lower than that of the non-cerebral infarction group( P < 0. 05).There were 52 patients( 55. 91%) developing cognitive dysfunction and 41( 44. 08%) patients with normal cognitive function.The results of multiple logistic regression analysis showed that age > 60,t Hcy greater than or equal to 15. 4 μmol/L,IGF-1 less than 140. 3 ng/ml,SBP greater than or equal to 140 mm Hg,and DBP greater than or equal to 90 mm Hg were independent risk factors for cognitive dysfunction in the patients with cerebral infarction( P < 0. 05).Conclusion Serum IGF-1 and t Hcy concentrations are independent risk factors for cognitive dysfunction in patients with cerebral infarction.Patients with cerebral infarction whose IGF-1 <140. 3 ng/ml or t Hcy> 15. 4 μmol/L have a higher risk of cognitive dysfunction.
Objective To analyze the expression levels of homocysteine( t Hcy) and insulin-like growth factor 1( IGF-1) in patients with cerebral infarction and their correlation with cognitive function.Methods The clinical data of 93 patients with cerebral infarction and 46 healthy patients who were treated in our hospital were retrospectively analyzed.The patients were divided into cerebral infarction and non-cerebral infarction group.The expression levels of t Hcy and IGF-1 were compared between the two groups.Based on cognitive function,the patients were divided into cognitive dysfunction group and normal cognitive group.The expression levels of t Hcy and IGF-1 level were compared the two groups.The influence factors related to cognitive dysfunction in the patients were analyzed.Results The t Hcy concentrations of the cerebral infarction group was significantly higher than that of the non-cerebral infarction group,and the IGF-1 concentration and MoCA score were significantly lower than that of the non-cerebral infarction group( P < 0. 05).There were 52 patients( 55. 91%) developing cognitive dysfunction and 41( 44. 08%) patients with normal cognitive function.The results of multiple logistic regression analysis showed that age > 60,t Hcy greater than or equal to 15. 4 μmol/L,IGF-1 less than 140. 3 ng/ml,SBP greater than or equal to 140 mm Hg,and DBP greater than or equal to 90 mm Hg were independent risk factors for cognitive dysfunction in the patients with cerebral infarction( P < 0. 05).Conclusion Serum IGF-1 and t Hcy concentrations are independent risk factors for cognitive dysfunction in patients with cerebral infarction.Patients with cerebral infarction whose IGF-1 <140. 3 ng/ml or t Hcy> 15. 4 μmol/L have a higher risk of cognitive dysfunction.
引文
[1]张丽雅.脑梗死患者认知功能障碍与高半胱氨酸及类胰岛素样生长因子-1的相关性分析[J].实用医院临床杂志,2017,43(3):44-46.
[2]张宝琴,董秦川,张应喜.2型糖尿病合并急性脑梗死患者血清胰岛素样生长因子-1水平的变化及与神经功能缺损评分的相关性[J].神经损伤与功能重建,2016,11(2):256-257.
[3]梁跃雄,常大川,曹丽,等.依达拉奉联合丁苯酞对脑梗死患者血浆B型脑钠肽前体(NT-proBNP)和D-二聚体水平的影响[J].解放军医药杂志,2016,28(8):77-80.
[4]赵智晗,朱慧艳,王宏,等.2型糖尿病并急性脑梗死患者血清胰岛素样生长因子-1水平与神经功能缺损及临床预后相关性[J].中华实用诊断与治疗杂志,2015,29(5):441-443.
[5]夏翠萍.急性脑梗死患者监测Ngb、BDNF和MBP的临床意义[J].临床误诊误治,2016,29(12):81-84.
[6]陶海雁,王晓平.急性缺血性脑卒中患者血清胰岛素样生长因子-1水平变化与相关影响因素的研究[J].世界临床药物,2018,14(6):189-190.
[7]张军武,李培育.癫痫复杂部分性发作患者认知功能与磁共振波谱及血清BDNF、IGF-1水平的相关性分析[J].检验医学与临床,2018,24(2):237-239.
[8]刘慧影.依达拉奉联合胞二磷胆碱治疗急性缺血性脑梗死的疗效[J].保健医学研究与实践,2016,13(5):51-52.
[9]赵建国,高长玉,顼宝玉,等.脑梗死和脑出血中西医结合诊断标准(试行)[J].中国中西医结合杂志,2006,26(10):948-949.
[10]邹海强,马敬红.帕金森病轻度认知功能障碍的诊断标准:运动障碍协会工作组指南[J].中华临床医师杂志(电子版),2012,6(19):6013-6017.
[11]汪兰兰,康冬梅,朱文静,等.老年男性病人胰岛素样生长因子-1水平与生活质量及营养状态的相关性分析[J].蚌埠医学院学报,2017,42(8):1036-1038.
[12]郭义君,郑平,童武松,等.急性颅脑损伤病人血清IGF-1动态变化与认知功能障碍的相关性研究[J].中国微侵袭神经外科杂志,2017,22(6):241-244.
[13]李杰玉,郭权,张静,等.2型糖尿病伴脑梗死患者血清胰岛素样生长因子-1、铁蛋白水平的变化及其临床意义[J].中国糖尿病杂志,2016,24(4):352-355.
[14]戢运建,况娥.老年2型糖尿病合并急性脑梗死患者血清IGF-1水平与神经功能及颈动脉斑块的关系[J].卒中与神经疾病,2016,23(5):322-325.
[15]陈思,陆斌,尹文伟,等.参芪扶正注射液对脑梗死恢复期患者血清IGF-1、瘦素及神经认知功能影响研究[J].辽宁中医杂志,2016,16(6):1235-1238.
[16]柳丰慧,张可帅.血清白介素6、基质金属蛋白酶9、基质金属蛋白酶抑制剂1、超敏C反应蛋白及神经生长因子水平与急性脑梗死患者神经功能缺损程度的关系研究[J].实用心脑肺血管病杂志,2017,25(1):35-38.
[17]董芳,杜怡峰.腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性[J].山东大学学报:医学版,2016,54(2):46-49.
[18]钱小蔷,徐宇浩,于明,等.尿激肽原酶与胰激肽原酶序贯治疗前循环非进展性脑梗死的效果观察[J].江苏大学学报(医学版),2017,27(2):176-178.
[19]刘小玲,李志伟,蒋锋,等.尤瑞克林对急性脑梗死后血管再生、单核细胞趋化蛋白-1及认知功能影响研究[J].广西医科大学学报,2017,23(1):1721-1724.
[20]郭义君,郑平,童武松,等.急性颅脑损伤病人血清IGF-1动态变化与认知功能障碍的相关性研究[J].中国微侵袭神经外科杂志,2017,22(6):241-244.
[21]许春花,薛东生,金正勇.胰岛素样生长因子1对新生大鼠高氧肺损伤的影响及其机制探讨[J].山东医药,2016,56(42):37-39.
[22]周青平,罗红艳,司马妮.子宫内膜异位症患者血清糖类抗原125、血管内皮生长因子和胰岛素样生长因子-1的表达及意义[J].中国妇幼保健,2017,32(9):1841-1844.
[23]于建敏,徐燕杰,耿纪录,等.前列地尔联合灯盏细辛对脑梗死并糖尿病患者血清同型半胱氨酸的影响[J].临床误诊误治,2017,30(3):92-94.
[24]孙成铭.急性脑梗死患者血清同型半胱氨酸、基质金属蛋白酶-9、血管内皮生长因子水平变化及意义[J].中国临床医生杂志,2018,18(6):124-125.
[25] Ren H,Cao X,Neurology DO. Effects of benazepril on hemodynamics,blood pressure and cognitive function of patients with cerebral infarction and hypertension[J].Journal of Clinical Medicine in Practice,2017,26(1):182-183.
[2]张宝琴,董秦川,张应喜.2型糖尿病合并急性脑梗死患者血清胰岛素样生长因子-1水平的变化及与神经功能缺损评分的相关性[J].神经损伤与功能重建,2016,11(2):256-257.
[3]梁跃雄,常大川,曹丽,等.依达拉奉联合丁苯酞对脑梗死患者血浆B型脑钠肽前体(NT-proBNP)和D-二聚体水平的影响[J].解放军医药杂志,2016,28(8):77-80.
[4]赵智晗,朱慧艳,王宏,等.2型糖尿病并急性脑梗死患者血清胰岛素样生长因子-1水平与神经功能缺损及临床预后相关性[J].中华实用诊断与治疗杂志,2015,29(5):441-443.
[5]夏翠萍.急性脑梗死患者监测Ngb、BDNF和MBP的临床意义[J].临床误诊误治,2016,29(12):81-84.
[6]陶海雁,王晓平.急性缺血性脑卒中患者血清胰岛素样生长因子-1水平变化与相关影响因素的研究[J].世界临床药物,2018,14(6):189-190.
[7]张军武,李培育.癫痫复杂部分性发作患者认知功能与磁共振波谱及血清BDNF、IGF-1水平的相关性分析[J].检验医学与临床,2018,24(2):237-239.
[8]刘慧影.依达拉奉联合胞二磷胆碱治疗急性缺血性脑梗死的疗效[J].保健医学研究与实践,2016,13(5):51-52.
[9]赵建国,高长玉,顼宝玉,等.脑梗死和脑出血中西医结合诊断标准(试行)[J].中国中西医结合杂志,2006,26(10):948-949.
[10]邹海强,马敬红.帕金森病轻度认知功能障碍的诊断标准:运动障碍协会工作组指南[J].中华临床医师杂志(电子版),2012,6(19):6013-6017.
[11]汪兰兰,康冬梅,朱文静,等.老年男性病人胰岛素样生长因子-1水平与生活质量及营养状态的相关性分析[J].蚌埠医学院学报,2017,42(8):1036-1038.
[12]郭义君,郑平,童武松,等.急性颅脑损伤病人血清IGF-1动态变化与认知功能障碍的相关性研究[J].中国微侵袭神经外科杂志,2017,22(6):241-244.
[13]李杰玉,郭权,张静,等.2型糖尿病伴脑梗死患者血清胰岛素样生长因子-1、铁蛋白水平的变化及其临床意义[J].中国糖尿病杂志,2016,24(4):352-355.
[14]戢运建,况娥.老年2型糖尿病合并急性脑梗死患者血清IGF-1水平与神经功能及颈动脉斑块的关系[J].卒中与神经疾病,2016,23(5):322-325.
[15]陈思,陆斌,尹文伟,等.参芪扶正注射液对脑梗死恢复期患者血清IGF-1、瘦素及神经认知功能影响研究[J].辽宁中医杂志,2016,16(6):1235-1238.
[16]柳丰慧,张可帅.血清白介素6、基质金属蛋白酶9、基质金属蛋白酶抑制剂1、超敏C反应蛋白及神经生长因子水平与急性脑梗死患者神经功能缺损程度的关系研究[J].实用心脑肺血管病杂志,2017,25(1):35-38.
[17]董芳,杜怡峰.腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性[J].山东大学学报:医学版,2016,54(2):46-49.
[18]钱小蔷,徐宇浩,于明,等.尿激肽原酶与胰激肽原酶序贯治疗前循环非进展性脑梗死的效果观察[J].江苏大学学报(医学版),2017,27(2):176-178.
[19]刘小玲,李志伟,蒋锋,等.尤瑞克林对急性脑梗死后血管再生、单核细胞趋化蛋白-1及认知功能影响研究[J].广西医科大学学报,2017,23(1):1721-1724.
[20]郭义君,郑平,童武松,等.急性颅脑损伤病人血清IGF-1动态变化与认知功能障碍的相关性研究[J].中国微侵袭神经外科杂志,2017,22(6):241-244.
[21]许春花,薛东生,金正勇.胰岛素样生长因子1对新生大鼠高氧肺损伤的影响及其机制探讨[J].山东医药,2016,56(42):37-39.
[22]周青平,罗红艳,司马妮.子宫内膜异位症患者血清糖类抗原125、血管内皮生长因子和胰岛素样生长因子-1的表达及意义[J].中国妇幼保健,2017,32(9):1841-1844.
[23]于建敏,徐燕杰,耿纪录,等.前列地尔联合灯盏细辛对脑梗死并糖尿病患者血清同型半胱氨酸的影响[J].临床误诊误治,2017,30(3):92-94.
[24]孙成铭.急性脑梗死患者血清同型半胱氨酸、基质金属蛋白酶-9、血管内皮生长因子水平变化及意义[J].中国临床医生杂志,2018,18(6):124-125.
[25] Ren H,Cao X,Neurology DO. Effects of benazepril on hemodynamics,blood pressure and cognitive function of patients with cerebral infarction and hypertension[J].Journal of Clinical Medicine in Practice,2017,26(1):182-183.