血清中胰岛素样生长因子-1水平与脑卒中后痴呆关系的研究

目的研究血清胰岛素样生长因子-1(IGF-1)水平与脑卒中后痴呆(post-stroke dementia,PSD)的关系。方法同期选择脑卒中患者129例作为脑卒中组,其他疾病患者76例为对照组,健康老年人41例为正常组。6个月后将脑卒中组患者按其是否符合痴呆诊断标准又分为PSD组(65例)和非PSD组(64例),发病时及6个月后测血IGF-1及认知功能量表测定。结果脑卒中组IGF-1水平比对照组低,差异无显著性意义(t=-1.88,P=0.06),与正常组比较,则差异有显著性意义(t=-2.79,P=0.006);PSD组IGF-1水平比其他3组均低,4组间组内比较,差异有显著性意义(F=3.43,P=0.013);发病6个月后,PSD组IGF-1保持较低水平;logistic回归方程发现与PSD相关的危险因素包括年龄、收缩压I、GF-1及冠心病、高血压。相关分析发现血IGF-1水平与一般认知功能水平相关,其中空间结构能力、注意、短时记忆与瞬间记忆受影响比较明显(P<0.05)。结论脑卒中发病时低IGF-1水平者,其发生PSD的可能性大;血IGF-1水平与认知功能存在一定的相关性。

The study of relationship between serum insulin-like growth factor 1 and post-stroke dementia

Objectives To study the serum level of insulin-like growth factor 1(IGF-1) in the patients with stroke,and the relationship between IGF-1 and cognitive functions.Methods 129 stroke patients were divided into 2 groups:post-stroke dementia group and post-stroke subjects without dementia group.Seventy-six patients with other diseases served as control group.Forty-one healthy elderly constituted the normal elderly group.There were no significant differences in sex and age between different groups.Plasma IGF-1 level,cholesterol,triglyceride,plasma free glucose,postprandial blood sugar,history of hypertension,diabetes mellitus,coronary heart disease,cerebral infarction and cerebral hemorrhage were analyzed.Neuropsychological tests were also performed in these subjects.Results There was lower level of IGF-1 in the subjects with stroke than in the controls,but no significant difference.The level of IGF-1 was also lower in the stroke group than in the normal elders group with statistically significant difference.The level of plasma IGF-1 in post-stroke dementia group was the lowest among all four groups.After half a year, the IGF-1 level in post-stroke dementia patients was still the lowest.Logistic regression analysis showed that age,systolic blood pressure,IGF-1,hypertension and coronary heart disease were the risk factors for post-stroke dementia.Correlation analysis showed that plasma IGF-1 level had significant relationships with shortterm memory,attention and spatial structure ability.Conclusions The stroke patients with low plasma IGF-1 level may be more apt to suffer from post-stroke dementia.There was certain relationship between plasma IGF-1 level and cognitive function.