缺血性脑白质病变与认知功能、血浆热休克蛋白70水平的相关分析

目的:探讨不同程度缺血性脑白质病变（WMIL）对认知功能的影响及其与血浆热休克蛋白70（HSP70）的相关性。方法:根据头颅MRI检查结果，选取WMIL患者75例，根据 Fazekas分级量表评分将WMIL患者分为轻度组、中度组和重度组。纳入同期正常对照者40名作为对照组。应用蒙特利尔认知功能评估（MoCA）量表对研究对象进行认知功能评估；采用酶联免疫吸附试验测定研究对象血浆HSP70水平。结果:轻、中、重度WMIL患者的MoCA总分、视空间与执行功能和延迟回忆评分均明显低于对照组（P < 0.01），而重度WMIL患者的计算力和注意力评分亦均低于对照组（P < 0.05）。WMIL的Fazekas评分与MoCA评分呈明显负相关关系（P < 0.01）。轻、中、重度WMIL患者的血浆HSP70水平均明显高于对照组（P < 0.01）。 WMIL的Fazekas评分与血浆HSP70水平呈显著正相关关系（P < 0.01）。结论:WMIL程度越重，认知功能损害越严重，血浆HSP70水平增高越明显。血浆HSP70水平作为评估WMIL严重程度的生化指标具有一定的临床意义。

Analysis of the correlation between ischemic white matter lesions,and cognitive function and plasma level of heat shock protein 70

Objective: To investigate the effects of the different extent white matter ischemic lesions(WMIL) on the cognitive function,and correlation of plasma heat shock protein 70(HSP70) level with WMIL.Methods: According to the results of head MRI,75 patients with WMIL were selected.The patients were divided into the mild group,moderate group and severe group according to the Fazekas rating scale,and 40 cases normal people were set as the control group.The cognitive function were evaluated using the Montreal Cognitive Assessment(MoCA) scale,and the levels of HSP70 were measured using the enzyme-linked immunosorbent assay in four groups.Results: The scores of total MoCA,visual space,executive function and delayed memory ability in mild,moderate and severe group were significantly lower than those in control group(P < 0.01),the scores of attention and calculation in severe group were also lower than those in control group(P < 0.05).The score of Fazekas was significantly negative correlation with the score of MoCA(P < 0.01).The plasma levels of HSP70 in mild,moderate and severe group were significantly higher than that in control group(P < 0.01).The score of Fazekas was significantly positive correlation with the score of HSP70(P < 0.01).Conclusions: With the WMIL severity aggravating,the cognitive impairment is more severe,and the plasma HSP70 level is more high.The HSP70 may play certain clinical significance in evaluating the severity of WMIL.