首页|老年血管性痴呆患者血清ANGPTL4和sTLT-1水平表达与其认知功能及预后的相关性研究

老年血管性痴呆患者血清ANGPTL4和sTLT-1水平表达与其认知功能及预后的相关性研究

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目的 探讨老年血管性痴呆(vascular dementia,VD)患者血清血管生成素样蛋白4(angiopoietin-like protein 4,ANGPTL4)、可溶性骨髓细胞样转录因子-1(soluble bone marrow cell-like transcription factor-1,sTLT-1)水平表达与其认知功能和预后的相关性研究.方法 选取2020年6月~2022年6月在河北燕达医院收治的92例老年血管性痴呆患者作为研究组,根据简易精神状态量表(minimum mental state examination,MMSE)评分分为轻度组(n=30)、中度组(n=36)和重度组(n=26),另选取同期健康体检者92例作为对照组.根据患者预后认知功能障碍情况分为Ⅰ~Ⅱ级和Ⅲ级;采用ELISA方法检测各组血清ANGPTL4和sTLT-1水平,采用Pearson和Spearman法分析血清ANGPTL4,sTLT-1与MOCA评分的相关性;采用Logistic回归分析老年血管性痴呆患者预后分级为Ⅲ级的影响因素;绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析血清ANGPTL4和sTLT-1水平对老年血管性痴呆患者预后分级为Ⅲ级的预测价值.结果 研究组血清ANGPTL4(987.57±53.25 pg/ml)水平显著低于对照组(1 108.35±62.13 pg/ml),血清sTLT-1(68.01±5.15 pg/ml)水平显著高于对照组(50.12±4.57 pg/ml),差异具有统计学意义(t=14.158,24.922,均P<0.05).轻度、中度和重度组血清ANGPTL4水平和MOCA评分依次降低(F=33.495,66.617),血清sTLT-1水平依次升高(F=66.718),差异具有统计学意义(均P<0.05).Pearson法分析显示,血清ANGPTL4与sTLT-1呈负相关(r=-0.621,P<0.05),Spearman 法分析显示,血清 ANGPTL4 与 MoCA 评分呈正相关(r=0.545,P<0.05),sTLT-1 水平与 MoCA 评分呈负相关(r=-0.557,P<0.05).Ⅲ 级预后患者血清 ANGPTL4(953.45±51.16 pg/ml)水平显著低于 Ⅰ~Ⅱ级(1 005.76±54.27 pg/mL),血清 sTLT-1(73.14±5.40pg/ml)水平显著高于 Ⅰ~Ⅱ 级(65.28±5.02 pg/ml),差异具有统计学意义(t=4.490,6.967,均P<0.05).Logistic回归分析得知,ANGPTL4低表达[OR(95%CI):5.089(1.833~14.129)],sTLT-1 高表达[OR(95%CI):4.258(1.739~10.428)]均为影响老年血管性痴呆患者预后分级为Ⅲ级的危险因素(P<0.05).根据ROC曲线得知,二者联合预测老年血管性痴呆患者预后分级为Ⅲ级优于ANGPTL4和sTLT-1各自单独预测(Z=2.135,3.268,均P<0.05).结论 老年血管性痴呆患者血清ANGPTL4水平显著降低,sTLT-1水平显著升高,ANGPTL4和sTLT-1与认知功能和预后密切相关.
Correlation between Serum Levels of ANGPTL4 and sTLT-1 and Cognitive Function and Prognosis in Elderly Patients with Vascular Dementia
Objective To investigate the correlation between serum Angiopoietin-like protein 4(ANGPTL4)and soluble bone marrow cell-like transcription factor-1(sTLT-1)levels and cognitive function and prognosis in elderly patients with vascular dementia(VD).Methods A total of 92 elderly patients with vascular dementia admitted to Hebei Yanda Hospital from June 2020 to June 2022 were selected as the study group.They were divided into mild(n=30),moderate(n=36)and severe groups(n=26)according to the minimum mental state examination(MMSE)score,and 92 patients with healthy physical examination during the same period were selected as the control group.According to the prognosis of patients,the cognitive dysfunction was divided into grade Ⅰ~Ⅱ and grade Ⅲ.ELISA method was used to detect the levels of serum ANGPTL4 and sTLT-1.Pearson and Spearman methods were used to analyze the correlation between serum ANGPTL4 and sTLT-1 and MOCA scores.Logistic regression analysis was used to analyze the influencing factors of the prognostic grade Ⅲ of elderly patients with vascular dementia.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum ANGPTL4 and sTLT-1 levels in the prognostic grade Ⅲ in elderly patients with vascular dementia.Results The serum ANGPTL4 level(987.57±53.25 pg/ml)in the study group was lower than that in the control group(1 108.35±62.13 pg/ml),and the serum sTLT-1(68.01±5.15 pg/ml)level was higher than that in the control group(50.12±4.57 pg/ml),with significant differences(t=14.158,24.922,all P<0.05).Serum ANGPTL4 levels and MOCA scores were decreased sequentially in the mild,moderate and severe groups(F=33.495,66.617),while serum sTLT-1 level was increased sequentially(F=66.718),and the differences were statistically significant(all P<0.05),respective.Pearson analysis showed that serum ANGPTL4 was negatively correlated with sTLT-1(r=-0.621,P<0.05).Spearman analysis showed serum levels of ANGPTL4 and sTLT-1 were positively and negatively correlated with MoCA scores,respectively(r=0.545,-0.557,all P<0.05).The serum ANGPTL4 level(953.45±51.16 pg/ml)in the prognostic patients of grade Ⅲ was lower than that of grade Ⅰ~Ⅱ(1 005.76±54.27 pg/ml),and the serum level of sTLT-1(73.14±5.40 pg/ml)was higher than that of grade Ⅰ~Ⅱ(65.28±5.02 pg/ml),with significant differences(t=4.490,6.967,all P<0.05).Logistic regression analysis showed low expression of ANGPTL4[OR(95%CI):5.089(1.833~14.129)]and high expression of sTLT-1[OR(95%CI):4.258(1.739~10.428)]were risk factors affecting the prognosis of elderly patients with vascular dementia(P<0.05).According to the ROC curve,the combined prediction of two for the grade Ⅲ prognosis of elderly vascular dementia patients was better than the individual prediction of ANGPTL4 and sTLT-1(Z=2.135,3.268,all P<0.05).Conclusion Serum ANGPTL4 level was decreased but sTLT-1 level was increased in elderly patients with vascular dementia,and ANGPTL4 and sTLT-1 were closely related to cognitive function and prognosis.

vascular dementiaangiopoietin-like protein 4soluble bone marrow cell-like transcription factor-1cognitive function

靳玉娟、王鹏飞、王诗男、陈长英

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河北燕达医院急诊医学科,河北廊坊 065201

河北燕达医院老年医学科,河北廊坊 065201

河北燕达医院神经内科,河北廊坊 065201

血管性痴呆 血管生成素样蛋白4 可溶性骨髓细胞样转录因子-1 认知功能

廊坊市科学技术研究与发展计划项目

2022013006

2024

现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

CSTPCD
影响因子:0.713
ISSN:1671-7414
年,卷(期):2024.39(4)