摘要
目的:探讨8-异构前列腺素（8-iso-PGF2α）及P选择素在评估脑小血管病患者认知功能中的价值。方法:选择2019年6月至2022年9月甘肃省武威肿瘤医院收治的脑小血管病患者99例为病例组，另取同期接受体格检查的50例健康个体为对照组，采用酶联免疫吸附法（ELISA）测定2组8-iso-PGF2α、P选择素水平并进行比较；采用Pearson相关性分析病例组患者8-iso-PGF2α、P选择素水平与蒙特利尔认知评估（MoCA）量表评分的相关性，以弥散张量成像结果将病例组患者分为认知障碍亚组（42例）和非认知障碍亚组（57例），并采用受试者工作特征曲线（ROC）分析8-iso-PGF2α、P选择素对脑小血管病患者认知功能障碍的预测价值。结果:（1）病例组患者的血清8-iso-PGF2α、P选择素水平均明显高于对照组，差异均有统计学意义[（220.69±50.16）pg/ml vs（95.13±16.59）pg/ml，t=17.206，P＜0.001；（80.49±12.56）μg/L vs（13.59±6.98）μg/L，t=34.995，P＜0.001]。（2）Pearson相关性分析显示，病例组患者血清8-iso-PGF2α、P选择素水平与其MoCA评分存在一定的负相关（r=-0.4840，P＜0.0001；r=-0.4216，P＜0.0001）。（3）认知障碍亚组患者的血清8-iso-PGF2α、P选择素水平明显高于非认知障碍亚组[（245.21±23.56）pg/ml vs（198.52±20.56）pg/ml，t=10.277，P＜0.001；（92.01±10.45）μg/L vs（79.89±9.68）μg/L，t=5.883，P＜0.001]，MoCA评分明显低于非认知障碍亚组[（24.51±1.98）分 vs（27.16±2.12）分，t=6.320，P＜0.001]，差异均有统计学意义。（4）8-iso-PGF2α、P选择素对脑小血管病患者认知功能障碍的预测曲线下面积（AUC）分别为0.8200（P=0.0156）和0.8000（P=0.0233）。结论:8-iso-PGF2α、P选择素对脑小血管病患者认知功能的评估具有一定的应用价值。
Abstract
Objective:To explore the value of 8-iso-PGF2α and P selectin in evaluating cognitive function of patients with cerebral small vessel disease.Methods:99 patients with cerebrovascular disease admitted to Wuwei Cancer Hospital of Gansu Province from September 2018 to August 2021 were included as the case group, and 50 healthy individuals who received physical examinations during the same period were included as the control group. 8-iso-PGF2α and P-selectin levels were determined by enzyme-linked immunosorbent assay, and were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between 8-iso-PGF2α, P-selectin level, and MoCA scores. The patients in the case group were divided into cognitive impairment subgroup (n=42) and non-cognitive impairment subgroup (n=57) according to the results of diffusion tensor imaging, and the predictive value of 8-iso-PGF2α and P-selectin on cognitive dysfunction in patients with cerebrovascular disease was analyzed by receiver operating characteristic curve (ROC).Results:(1) Serum 8-iso-PGF2α and P selectin level of patients in the case group were significantly higher than those in the control group, and the differences between groups were statistically significant [(220.69±50.16) pg/ml vs (95.13±16.59) pg/ml, t=17.206, P＜0.001; (80.49±12.56) μg/L vs (13.59±6.98) μg/L, t=34.995, P＜0.001]; (2) Pearson correlation analysis showed that, there was a negative correlation between serum 8-iso-PGF2α, P-selectin level and MoCA score of patients in the case group (r=-0.4840, P＜0.0001; r=-0.4216, P＜0.0001); (3) Serum 8-iso-PGF2α and P selectin level of patients with cognitive impairment subgroup were significantly higher than those of non-cognitive impairment subgroup [(245.21±23.56) pg/ml vs (198.52±20.56) pg/ml, t=10.277, P＜0.001; (92.01±10.45) μg/L vs (79.89±9.68) μg/L, t=5.883, P＜0.001], and MoCA score was significantly lower than that of non-cognitive impairment subgroup [(24.51±1.98) scores vs (27.16±2.12) scores, t=6.320, P＜0.001], and the differences between groups were statistically significant; (4) the AUC of 8-iso-PGF2α, P-selectin in predicting cognitive impairment of cerebrovascular disease was 0.8200 (P=0.0156) and 0.8000 (P=0.0233).Conclusion:8-iso-PGF2α and P-selectin have certain application value in the evaluation of cognitive function of patients with cerebral small vessel disease.
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