弥漫性轴索损伤BDNF及其Val66Met基因多态性与认知功能的相关性研究

目的探讨弥漫性轴索损伤（DAI）（Ⅱ型）患者伤后1个月血清脑源性神经营养因子（BDNF）水平及其Val66Met基因多态性与认知功能的关系。 方法选取晋江市医院神经外科自2015年8月至2020年8月收治的106例DAI（Ⅱ型）患者为病例组，选择同期来本院体检的105名健康体检者为对照组，采用第二版洛文斯顿作业疗法认知量表（LOTCA）、蒙特利尔评估量表中文版（MoCA）分别评估对照组和病例组伤后1个月时的认知功能；采用酶联免疫吸附试验测定2组研究对象的血清BDNF水平；聚合酶链反应-限制性片段长度多态性分析BDNF Val66Met基因多态性；多元逐步回归法分析病例组整体认知功能与BDNF及BDNF Val66Met基因多态性的相关性。 结果病例组伤后1个月相同基因亚型血清BDNF浓度均低于对照组，差异有统计学意义（P<0.05）；病例组Val/Val亚型血清BDNF浓度高于Val/Met、Met/Met亚型，差异有统计学意义（P<0.05），而Val/Met和Met/Met亚型血清BDNF浓度比较差异无统计学意义（P>0.05）。病例组患者3种基因亚型伤后1个月的LOTCA和MoCA评分均低于对照组，差异有统计学意义（P<0.05）；病例组Val/Val亚型评分高于Val/Met、Met/Met评分，差异有统计学意义（P<0.05），而Val/Met和Met/Met亚型评分比较，差异无统计学意义（P>0.05）。DAI（Ⅱ型）整体认知水平与BDNF Val66Met基因多态性、BDNF浓度具有线性回归关系（F=11.417，P<0.001），其具有一定的相关性（|β|=0.966、0.877；r=0.569、0.579）。 结论BDNF可影响DAI认知功能，其BDNF Val66Met基因多态性可能是影响DAI认知功能的风险因素之一。

Correlation study of the relationship between BDNF and its Val66Met gene polymorphism and cognition in patients with diffuse axonal injury

ObjectiveTo investigate the characteristics of cognitive impairment in patients with three subtypes of serum brain-derived neurotrophic factor (BDNF) and its gene Val66Met polymorphism one month after diffuse axonal injury (DAI) (type Ⅱ) injury. MethodsOne hundred and six patients with DAI (type II) in the Neurosurgery Department of Jinjiang Hospital from August 2015 to August 2020 were selected as the case group, and 105 healthy people who came to our hospital for physical examination in the same period were selected as the control group. The second edition of Loewenstein occupational therapy cognitive assessment (LOTCA) and Montreal cognitive assessment (MoCA) were used to evaluate the cognitive function of the control group and the case group at 1 month after injury; The levels of serum BDNF in the two groups were measured by enzyme-linked immunosorbent assay; Polymerase chain reaction restriction fragment length polymorphism analysis BDNF Val66Met gene polymorphism; The correlation between the overall cognitive function and BDNF and BDNF Val66Met gene polymorphism was analyzed by multiple stepwise regression. ResultsThe concentration of serum BDNF of the same gene subtype in the case group was lower than that in the control group 1 month after injury, and the difference was statistically significant (P<0.05). The serum BDNF concentration of Val/Val subtype was significantly higher than that of Val/Met and Met/Met subtype in case group (P<0.05), but there was no significant difference in serum BDNF concentration between Val/Met and Met/Met subtypes (P>0.05). The LOTCA and MoCA scores of the three gene subtypes in the case group were lower than those in the control group 1 month after injury (P<0.05). The score of Val/Val subtype in case group was significantly higher than that of Val/Met and Met/Met (P<005), but there was no significant difference in the scores of Val/Met and Met/Met subtypes (P>0.05). The overall cognitive level of DAI (typeⅡ) had a linear regression relationship with BDNF Val66Met gene polymorphism and BDNF concentration (F=11.417, P<0.001), and it had a certain relationship (|β|=0.966, 0.877; r=0.569, 0.579). ConclusionBDNF may affect cognitive function in patients with diffuse axonal injury. The BDNF Val66Met polymorphism maybe one of the genetic factors in the cognitive function after DAI.