吴纪霞, 温振东, 梁友宝, 张珍, 董雪. 血清神经丝蛋白轻链对卒中后认知障碍的临床意义[J]. 蚌埠医学院学报, 2021, 46(9): 1187-1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.009
    引用本文: 吴纪霞, 温振东, 梁友宝, 张珍, 董雪. 血清神经丝蛋白轻链对卒中后认知障碍的临床意义[J]. 蚌埠医学院学报, 2021, 46(9): 1187-1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.009
    WU Ji-xia, WEN Zhen-dong, LIANG You-bao, ZHANG Zhen, DONG Xue. Clinical significance of serum neurofilament light chain on post-stroke cognitive impairment[J]. Journal of Bengbu Medical College, 2021, 46(9): 1187-1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.009
    Citation: WU Ji-xia, WEN Zhen-dong, LIANG You-bao, ZHANG Zhen, DONG Xue. Clinical significance of serum neurofilament light chain on post-stroke cognitive impairment[J]. Journal of Bengbu Medical College, 2021, 46(9): 1187-1191. DOI: 10.13898/j.cnki.issn.1000-2200.2021.09.009

    血清神经丝蛋白轻链对卒中后认知障碍的临床意义

    Clinical significance of serum neurofilament light chain on post-stroke cognitive impairment

    • 摘要:
      目的探讨血清神经丝轻链蛋白(NfL)与卒中后认知障碍(PSCI)的相关性及其临床意义。
      方法选取正常健康体检者60名(HC组),急性缺血性脑卒中(AIS)病人60例(AIS组),利用蒙特利尔认知评估量表(MoCA)进行评定为PSCI病人60例(PSCI组),采用电化学发光免疫法检测NfL含量,并进行美国国立卫生院卒中量表(NIHSS)、MoCA、日常生活活动能力量表(Barthel index,BI)、改良Rankin量表(mRS)神经心理评估和生化指标的检测。
      结果血清NfL在HC组、AIS组和PSCI组的含量有显著差异,神经系统损伤越重NIHSS评分越高,NfL含量越高(r=0.724,P < 0.01);生活自理能力越差,BI分数越低,NfL含量越高(r=-0.670,P < 0.01);认知功能越差,MoCA评分越低,NfL含量越高(r=-0.707,P < 0.01);不同认知障碍NfL含量不同,轻度认知障碍NfL含量低于中重度(P < 0.05);血清NfL含量与mRS呈正相关关系(r=0.501,P < 0.01),血清NfL含量越高,神经恢复功能越差。高脂血症、高血压史、糖尿病、卒中史差异有统计学意义(P < 0.01),生化指标中高同型半胱氨酸差异有统计学意义(P < 0.01);PSCI的NfL含量ROC曲线下面积为0.810(P < 0.01)。
      结论NfL可作为早期诊断PSCI发生的生物标志物和预测PSCI严重性的新兴标志物,对PSCI的早发现、早防治具有积极的临床意义。

       

      Abstract:
      ObjectiveTo investigate the correlation between serum neurofilament light chain (NfL) and post-stroke cognitive impairment (PSCI) and its clinical significance.
      MethodsSixty health-examination people, 60 patients with acute ischemic stroke (AIS) and 60 patients with PSCI by Montreal congnitive assessment scale(MoCA) were selected.Electrochemiluminescence was used to detect the NfL content in peripheral blood for health control (HC) group, AIS group, and PSCI group.National Institutes of Health stroke scale (NIHSS), MoCA, Barthel index(BI) and biochemical indexes, and modified rankin scale(mRS) were measured in the three groups.
      ResultsThere were significant differences in the levels of serum NfL in HC group, AIS group, and PSCI group.The NfL content increased with the increase of nervous system damage and NIHSS score(r=0.724, P < 0.01), increased with with the decrease of self-care ability and BI score(r=-0.670, P < 0.01), and increased with the decrease of cognitive function and MoCA score(r=-0.707, P < 0.01).The NfL content of mild cognitive impairment was lower than that of moderate and severe cognitive impairment.There was also a positive correlation between serum NfL and mRS(r=0.501, P < 0.01), The NfL content increased with the decrease of nerve recovery function.In three groups, there were significant differences in hyperlipidemia, hypertension history, diabetes, and stroke history(P < 0.01), and the difference of biochemical indicator homocysteine was statistically significant(P < 0.01).The area under receiver operating characteristic curve of NfL in PSCI was 0.810(P < 0.01).
      ConclusionsNfL content can be used as a biomarker for early diagnosis of PSCI and a novel predictor of the severity of PSCI, which has positive clinical significance for early detection and prevention of PSCI.

       

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