河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (6): 632-637.doi: 10.3969/j.issn.1007-3205.2024.06.003

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急性脑梗死患者侧支循环建立状况下血清PGRN和SDF-1水平与认知功能障碍的相关性研究

  

  1. 1.西安交通大学第一附属医院检验科，陕西 西安 710061；2.西安医学高等专科学校附属医院检验科，
    陕西 西安 710309；3.空军军医大学第二附属医院检验科，陕西  西安 710038

  • 出版日期:2024-06-25 发布日期:2024-06-25
  • 作者简介:刘懿（1986-），女，陕西西安人，西安交通大学第一附属医院主管技师，医学学士，从事医学检验研究。
  • 基金资助:
    陕西省创新能力支撑计划项目（2020PT-007）

The correlation between serum PGRN and SDF-1 levels and cognitive impairment in patients with acute cerebral infarction under the condition of collateral circulation establishment

  1. 1.Department of Laboratory Medicine, the First Affiliated Hospital of Xi′an Jiaotong University, 
    Shaanxi Province, Xi′an 710061, China; 2.Department of Laboratory Medicine, the Affiliated 
    Hospital of Xi′an Medical College, Shaanxi Province, Xi′an 710309, China; 3.Department of 
    Laboratory Medicine, the Second Affiliated Hospital of Air Force Military 
    Medical University, Shaanxi Province, Xi′an 710000, China

  • Online:2024-06-25 Published:2024-06-25

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摘要： 目的 探讨血清颗粒蛋白前体（progranulin，PGRN）及基质细胞衍生因子1（stromal-derived factor-1，SDF-1）水平与急性脑梗死（acute cerebral infarction，ACI）患者支循环建立状况下认知功能障碍的相关性。
 方法 选择ACI患者130例作为研究对象。依据患者脑侧支循环状态的评估分为侧支循环良好（fine collateral circulation，FCC;72例）组和侧支循环不良（poor collateral circulation，PCC;58例）组。血清PGRN及SDF-1水平采用酶联免疫吸附法检测。认知功能采用蒙特利尔认知评估量表（Montreal Cognitive Assessment Scale，MoCA）评估。比较分析以上指标的变化与急性脑梗死后认知功能障碍的相关性。
 结果 PCC组SDF-1水平比FCC组增加（t=2.705，P＜0.05），PGRN水平降低（t=5.747，P＜0.05）。PCC组的MoCA评分低于FCC组（t=5.302，P＜0.05）。ACI患者的血清PGRN和SDF-1水平呈负相关性（r=-0.289，P＜0.05）。 ACI患者的PGRN水平与MoCA评分呈正相关性（r=0.203，P＜0.05）；SDF-1水平与MoCA评分呈负相关性（r=-0.204，P＜0.05）。ACI患者的血清PGRN和SDF-1及联合检测诊断认知功能障碍的曲线下面积分别为0.795（95%CI:0.709~0.888，P＜0.01）；0.727（95%CI:0.636~0.818，P＜0.01）；0.805（95%CI:0.727~0.884，P＜0.01）。PGRN和SDF-1及联合检测诊断认知功能障碍的敏感度和特异度分别为89.70%和53.40%、63.80%和91.40%、96.60%和51.70%。
 结论 分析ACI患者在侧支循环不同状况下血清PGRN和SDF-1水平与认知功能障碍的相关性，可以预测认知功能障碍的发生，进一步为认知功能障碍临床干预措施的选择提供理论指导。


关键词: 脑梗死, 侧支循环, 认知功能障碍

Abstract: Objective To investigate the correlation between serum levels of progranulin(PGRN) and stromal derived factor-1 (SDF-1) and acute cerebral infarction (ACI) under the condition of collateral circulation establishment. 
Methods A total of 130 ACI patients were selected as the research subjects. According to the evaluation of the patient′s status of cerebral collateral circulation, they were divided into two groups: fine collateral circulation (FCC; n=72) group and poor collateral circulation (PCC; n=58) group. The levels of serum PGRN and SDF-1 were detected by enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The correlation between changes in the above indicators and cognitive impairment after ACI was compared and analyzed. 
Results The SDF-1 level in the PCC group increased compared with the FCC group (t=2.705, P＜0.05), while the PGRN level decreased (t=5.747, P＜0.05). The MoCA score in the PCC group was lower than that in the FCC group (t=5.302, P＜0.05). There was a negative correlation between serum PGRN and SDF-1 levels in ACI patients (r=-0.289, P＜0.05). There was a positive correlation between PGRN level and MoCA score in ACI patients (r=0.203, P＜0.05), and a negative correlation between SDF-1 level and MoCA score (r=-0.204, P＜0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of serum PGRN and SDF-1 levels detected alone and in combination for the diagnosis of cognitive impairment in ACI patients was 0.795 (95%CI: 0.709-0.888, P＜0.01), 0.727 (95%CI: 0.636-0.818, P＜0.01), and 0.805 (95%CI: 0.727-0.884, P＜0.01), respectively. The sensitivity and specificity of PGRN and SDF-1 detected alone and in combination for the diagnosis of cognitive impairment were 89.70% vs. 53.40%, 63.80% vs. 91.40%, and 96.60% vs. 51.70%, respectively. 
Conclusion Analyzing the correlation between serum PGRN and SDF-1 levels and cognitive impairment in patients with ACI under different conditions of collateral circulation can predict the occurrence of cognitive impairment and provide the oretical guidance for the selection of clinical intervention measures for cognitive impairment. 


Key words: cerebralinfarction, collateral circulation, cognitive impairment

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