|
|
Relationship between serum lipoprotein-related phospholipase A2 and angiotensin 1-7 levels and vascular dementia in elderly patients with acute cerebral infarction |
CHU Jingxin1 WANG Yu2▲ LI Baoshan1 JIANG Yi1 LIN Qiumei1 |
1.Department of General Practice, Chongqing University Central Hospital Chongqing Emergency Medical Center, Chongqing 400014, China;
2.Clinical Skills Training Center, Chongqing University Central Hospital Chongqing Emergency Medical Center, Chongqing 400014, China |
|
|
Abstract Objective To investigate the relationship between serum lipoprotein-related phospholipase A2 (Lp-PLA2) and angiotensin 1-7 (Ang1-7) levels and vascular dementia (VaD) in elderly patients with acute cerebral infarction (ACI). Methods A total of 122 ACI patients admitted to Chongqing University Central Hospital from May 2018 to May 2020 were selected as study objects. They were divided into ACI-VaD group (54 cases) and ACI-NVaD group (68 cases) according to whether VaD was combined; according to clinical dementia rating scale, ACI-VaD group was divided into mild dementia group (13 cases), moderate dementia group (16 cases), and severe dementia group (25 cases). The serum Lp-PLA2 and Ang1-7 levels in each group were compared, the multivariate logistic regression analysis was used to analyze the influencing factors of VaD in elderly patients with ACI, and the ROC curve was used to analyze the predictive value of serum Lp-PLA2 and Ang1-7 levels in ACI complicated with VaD. Results There were statistically significant differences in serum total cholesterol, high density lipoprotein cholesterol, high-sensitivity C-reactive protein (hs-CRP), Lp-PLA2 and Ang1-7 between two groups (P < 0.05). The level of serum Lp-PLA2 in severe dementia group was higher than that in moderate dementia group and mild dementia group, and the level of serum Ang1-7 was lower than that in moderate dementia group and mild dementia group; the level of serum Lp-PLA2 in moderate dementia group was higher than that in mild dementia group, and the level of serum Ang1-7 in moderate dementia group was lower than that in mild dementia group, with statistical significance (all P < 0.05). Hs-CRP and Lp-PLA2 were independent risk factors for VaD in elderly patients with ACI (OR > 1, P < 0.05), Ang1-7 was an independent protective factor (OR < 1,P < 0.05). The area under the curve, sensitivity, specificity and accuracy of Lp-PLA2+Ang1-7 predicting elderly patients with ACI complicated with VaD were greater than those of Lp-PLA2 and Ang1-7 alone. Conclusion Serum Lp-PLA2 level is significantly increased and Ang1-7 level is significantly decreased in elderly ACI patients complicated with VAD, which are independent influencing factors for VAD, and combined detection could enhance the predictive value of VAD.
|
|
|
|
|
[1] 中国老年医学学会急诊医学分会.急性缺血性脑卒中急诊急救中国专家共识(2018)[J].临床急诊杂志,2018,19(6):351-359.
[2] 王陇德,刘建民,杨弋,等.我国脑卒中防治仍面临巨大挑战——《中国脑卒中防治报告2018》概要[J].中国循环杂志,2019,34(2):6-20.
[3] Ferro DA,van den Brink H,Exalto LG,et al. Clinical relevance of acute cerebral microinfarcts in vascular cognitive impairment [J]. Neurology,2019,92(14):e1558-e1566.
[4] 朱晓璐.血管性痴呆的作用机制研究及血管性痴呆的临床特征分析[D].扬州:扬州大学,2018.
[5] 于波心,张亚杰,王佳贺.血浆脂蛋白相关磷脂酶A2的研究进展[J].实用医学杂志,2018,34(8):1394-1396.
[6] Zhang L,Wang J,Liang J,et al. Propofol prevents human umbilical vein endothelial cell injury from Ang Ⅱ-induced apoptosis by activating the ACE2-(1-7)-Mas axis and eNOS phosphorylation [J]. PLoS One,2018,13(7):e0199373.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[8] 中国痴呆与认知障碍指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南(一):痴呆及其分类诊断标准[J].中华医学杂志,2018,98(13):965-970.
[9] Nasreddine ZS,Phillips NA,Bédirian V,et al. The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment [J]. J Am Geriatr Soc,2010, 53(4):695-699.
[10] Hachinski VC,Iliff LD,Zilhka L. Cerebral blood flow in dementia [J]. Arch Neurol NLM,1975,40:97-103.
[11] 中国老年医学学会认知障碍分会.临床痴呆评定量表简体中文版[J].中华老年医学杂志,2018,37(4):367-371.
[12] 王丹晨,邱玲.脂蛋白相关磷脂酶A2与缺血性脑卒中研究进展[J].标记免疫分析与临床,2018,25(9):1402-1405.
[13] 冯娜.冠心病患者冠脉狭窄程度与LP-PLA2和AT-Ⅲ的相关性[J].中国卫生工程学,2018,17(6):936-938.
[14] 刘洋,廖博,魏继棠.血浆CT-1 Ghrelin Lp-PLA2检测在冠心病中的临床价值[J].河北医学,2019,25(12):2108-2112.
[15] 王蓓芸,李京波.巨噬细胞自噬与老年常见疾病研究进展[J].中国临床研究,2017,30(9):1272-1274.
[16] Huiban M,Coello C,Wu K,et al. Investigation of the Brain Biodistribution of the Lipoprotein-Associated Phospholipase A2(Lp-PLA2)Inhibitor [18F]GSK2647544 in Healthy Male Subjects [J]. Mo Imaging Biol,2017,19(1):153-161.
[17] 崔凯,张勤,陈淅泠.阿尔茨海默病伴睡眠障碍患者ApoE基因多态性及血清Lp-PLA2水平研究[J].实用医学杂志,2017,33(23):3959-3962.
[18] Cai R,Huang R,Han J,et al. Lipoprotein-associated Phospholipase A2 Is Associated with Risk of Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes [J]. Sci Rep,2017,7(1):12311.
[19] 崔莉莉,李忠堂.磷脂酶A2在阿尔茨海默病中的作用机制及运动调控[J].河北体育学院学报,2017,31(1):67-71.
[20] Chakrabarty A,Liao Z,Mu Y,et al. Inflammatory Renin-Angiotensin System Disruption Attenuates Sensory Hyperinnervation and Mechanical Hypersensitivity in a Rat Model of Provoked Vestibulodynia [J]. J Pain,2017,19(3):264-277.
[21] 陈丹,郭玉金,杨梦琦,等.血管紧张素(1-7)的神经活性研究进展[J].中国临床药理学与治疗学,2018,23(12):1425-1430.
[22] 蒋腾,高丽,陆杰,等.血管紧张素-(1-7)对大鼠脑缺血再灌注损伤后核因子-κB及下游炎症因子的调控作用[J].中华神经医学杂志,2013,12(1):19-23.
[23] Hamias R,Rudich A,Greenberg G,et al. Angiotensin 1-7,but not the thrombin-cleaved osteopontin C-terminal fragment,attenuates osteopontin-mediated macrophage-induced endothelial-cell inflammation [J]. Inflamm Res,2018,67(3):265-275.
[24] Jiang T,Gao L,Lu J,et al. ACE2-Ang-(1-7)-Mas Axis in Brain:A Potential Target for Prevention and Treatment of Ischemic Stroke [J]. Curr Neuropharmacol,2013,11(2):209-217.
[25] 梁小娜,林娟,李新,等.复方丹参片及其拆方对血管性痴呆模型大鼠学习记忆能力的改善作用和机制探讨[J].中草药,2019,50(12):2884-2890. |
|
|
|