血清SAA、BDNF、ALP水平与脑卒中后并发血管性认知功能障碍的关系

目的 探讨血清淀粉样蛋白A(SAA)、脑源性神经营养因子(BDNF)和碱性磷酸酶(ALP)与脑卒中后并发血管性认知功能障碍的关系。 方法 选取2015年2月-2017年2月在攀枝花学院附属医院治疗的脑卒中患者167例,根据简易精神状态检查(MMSE),其中并发认知障碍患者71例(观察组),认知正常患者96例(对照组),检测并比较两组患者的血清SAA、BDNF和ALP水平,同时比较两组患者的年龄、性别等临床资料,以及不同认知功能障碍患者血清SAA、BDNF、ALP水平。 结果 观察组和对照组患者的性别、年龄、受教育年限、基础疾病、吸烟、病灶数及损伤部位比较差异均无统计学意义(P＜0.05);观察组患者的血清SAA和ALP分别为(1.80±0.61)mg/L和(90.41±8.16)U/L,明显高于对照组的(0.49±0.12)mg/L和(60.22±9.04)U/L,而BDNF为(4.68±1.06)ng/ml,明显低于对照组的(5.51±1.13)ng/ml,差异均有统计学意义(P＜0.05);重度认知功能障碍患者血清SSA和ALP明显高于轻度和中度者,而BDNF明显低于轻度和中度者,差异均有统计学意义(P＜0.05);中度认知功能障碍患者血清SAA和ALP明显高于轻度者,而BDNF明显低于轻度者,差异均有统计学意义(P＜0.05);血清SAA和ALP与MMSE评分呈负相关(r=-0.413和-0.402,P＜0.05),而BDNF与MMSE评分呈正相关(r=0.341,P＜0.05)。 结论 血清SAA、BDNF、ALP水平与脑卒中后并发血管性认知功能障碍有一定的关系,值得进一步研究。

Relationship between serum SSA,BDNF and ALP levels and vascular cognitive impairment after stroke

Objective To explore the relationship between serum amyloid A (SAA), brain derived neurotrophic factor (BDNF), alkaline phosphatase (ALP) and vascular cognitive impairment after stroke. Methods One hundred and sixty-seven patients with stroke were selected from Affiliated Hospital of Panzhihua University from February 2015 to February 2017. According to the Mini-Mental State Examination (MMSE), 71 patients with cognitive impairment (serving as the observation group) and 96 patients with normal cognition (serving as the control group) were detected. Serum levels of SAA, BDNF and ALP were detected and compared between the two groups; meanwhile, age, gender and other clinical information as well as serum levels of SAA, BDNF and ALP of patients with different degrees of cognitive impairment in the two groups were also compared. Results No statistically significant differences were found in gender, age, education years, basic diseases, smoking, the number of lesions and the injuried part between the observation group and the control group (all P<0.05). Serum levels of SAA and ALP were significantly higher in the observation group than in the control group ((1.80±0.61) mg/L vs. (0.49±0.12) mg/L, (90.41±8.16) U/L vs. (60.22±9.04)U/L), while serum level of BDNF was significantly lower in the observation group than in the control group ((4.68±1.06) ng/mL vs. (5.51±1.13) ng/mL), showing statistically significant differences (all P<0.05). Serum levels of SSA and ALP were both significantly higher in patients with severe cognitive impairment than in ones with mild and moderate, while serum level of BDNF was significantly lower in patients with severe cognitive impairment than in ones with mild and moderate, showing statistically significant differences (all P<0.05). Serum levels of SSA and ALP were both significantly higher in patients with moderate cognitive impairment with mild, but serum level of BDNF was significantly lower in patients with moderate cognitive impairment than in ones with mild, showing statistically significant differences (all P<0.05). Serum SAA and ALP were negatively correlated with MMSE score (r=-0.413, r=-0.402, P<0.05), while BDNF was positively correlated with MMSE score (r=0.341, P<0.05). Conclusions Serum levels of SAA, BDNF and ALP are associated with vascular cognitive impairment after stroke, which is worthy of further study.