[1]曹 娜,辜 蕊,赵晓玲,等.脑血管病患者血清PTGS2，CHI3L1表达水平及与认知功能障碍的相关研究[J].现代检验医学杂志,2024,39(01):112-117.[doi:10.3969/j.issn.1671-7414.2024.01.020]
　CAO Na,GU Rui,ZHAO Xiaoling,et al.Expression Levels of Serum PTGS2 and CHI3L1 in Patients with Cerebrovascular Disease and Their Correlation with Cognitive Impairment[J].Journal of Modern Laboratory Medicine,2024,39(01):112-117.[doi:10.3969/j.issn.1671-7414.2024.01.020]
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脑血管病患者血清PTGS2，CHI3L1表达水平及与认知功能障碍的相关研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年01期
页码:
112-117
栏目:
论著
出版日期:
2024-01-15

文章信息/Info

Title:
Expression Levels of Serum PTGS2 and CHI3L1 in Patients with Cerebrovascular Disease and Their Correlation with Cognitive Impairment
文章编号:
1671-7414（2024）01-112-06
作者:
曹 娜; 辜 蕊; 赵晓玲; 刘 艳
（西南交通大学附属医院/ 成都市第三人民医院神经内科，成都 610031）
Author(s):
CAO Na;  GU Rui;  ZHAO Xiaoling;  LIU Yan
（Department of Neurology, the Third People's Hospital of Chengdu/ Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China）
关键词:
脑血管病; 认知功能障碍; 前列腺素内过氧化物合酶2; 几丁质酶-3 样蛋白1
分类号:
R743；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.01.020
文献标志码:
A
摘要:
目的　研究血清前列腺素内过氧化物合酶2（prostaglandin-endoperoxide synthase 2，PTGS2）和几丁质酶-3 样蛋白1（chitinase-3-like protein 1，CHI3L1）水平与脑血管病所致认知功能障碍的相关性。方法　选取2020 年10 月～ 2022年10 月成都市第三人民医院收治的96 例脑血管病住院患者为研究对象。记录患者基本临床资料，酶联免疫吸附法（ELISA）检测血清PTGS2 和CHI3L1 水平，患者依据有无认知功能障碍分为正常组（n=60）和障碍组（n=36）；血清PTGS2 和CHI3L1 水平与空腹血糖（fasting blood glucose，FBG）、同型半胱氨酸（homocysteine，Hcy）的相关性采用Pearson 法分析；Logistic 回归模型判断血清PTGS2 和CHI3L1 是否可作为预测认知功能障碍的独立危险因素；绘制受试者工作特征（receiver operating characteristic，ROC）曲线，根据曲线下面积（area under the curve，AUC）分析血清PTGS2和CHI3L1 表达水平对脑血管病患者认知功能障碍的预测价值。结果　与正常组比较，障碍组血清PTGS2（29.30± 9.46 pg/ml vs 17.86 ± 5.40 pg/ml），CHI3L1（13.04 ± 4.06 pg/ml vs 7.51 ± 2.66 pg/ml）水平均升高，差异有统计学意义（t=7.553，8.065，均P ＜ 0.05）；多因素Logistic 回归分析结果显示，FBG（OR=3.612，95%CI：2.324 ～ 5.614），Hcy（OR=2.584，95%CI：1.351 ～ 4.944），PTGS2（OR=1.964，95%CI：1.194 ～ 3.231） 和CHI3L1（OR=1.556，95%CI：1.023 ～ 2.367）是认知功能障碍的独立危险因素（均P ＜ 0.05）；PTGS2 与FBG，Hcy 呈正相关（r=0.368，0.551，均P<0.05），CHI3L1 与FBG，Hcy 呈正相关（r=0.510，0.376，均P<0.05）。ROC 曲线显示，PTGS2 预测认知功能障碍的AUC 为0.819，CHI3L1 预测认知功能障碍的AUC 为0.829，二者联合预测认知功能障碍的AUC 为0.902，高于二者单独预测（Z=2.089，2.293；P=0.037，0.021），其敏感度和特异度分别为77.78%，98.33%。结论　PTGS2 和CHI3L1 在脑血管病认知功能障碍患者血清中高表达，二者均与脑血管病患者认知功能障碍有关。
Abstract:
Objective　To investigate the correlation between serum levels of prostaglandin-endoperoxide synthase 2 (PTGS2), chitinase-3-like protein 1 (CHI3L1) and cognitive impairment caused by cerebrovascular disease. Methods　From October 2020 to October 2022, 96 inpatients with cerebrovascular diseases admitted to the Third People’s Hospital of Chengdu were regarded as the study subjects. The basic clinical data of the patients were recorded, the serum levels of PTGS2 and CHI3L1 were detected by enzyme-linked immunosorbent assay, and these patients were grouped into normal group (n=60) and impaired group (n=36) based on the presence or absence of cognitive impairment. The correlation between serum PTGS2 and CHI3L1 levels and fasting blood glucose (FBG) and homocysteine (Hcy) was analyzed by Pearson method. Logistic regression model was used to determine whether serum PTGS2 and CHI3L1 were independent risk factors for predicting cognitive impairment. Receiver operating characteristic (ROC) curve was drawn, and the predictive value of CHI3L1 and serum PTGS2 expression level in cognitive impairment in patients with cerebrovascular disease was analyzed according to the area under the curve (AUC). Results　 Compared with the normal group, the levels of serum PTGS2 (29.30 ± 9.46 pg/ml vs 17.86 ± 5.40 pg/ml) and CHI3L1 (13.04 ± 4.06 pg/ml vs 7.51 ± 2.66 pg/ml) in the disorder group were increased, and the differences were statistically significant (t=7.553, 8.065, all P<0.05). Multivariate Logistic regression analysis showed that FBG (OR=3.612, 95%CI:2.324 ～ 5.614), Hcy (OR=2.584, 95%CI:1.351 ～ 4.944), PTGS2 (OR=1.964, 95%CI:1.194 ～ 3.231) and CHI3L1 (OR= 1.556, 95%CI:1.023 ～ 2.367) were independent risk factors of cognitive impairment (all P<0.05). PTGS2 was positively correlated with FBG and Hcy (r=0.368, 0.551, all P<0.05), and CHI3L1 was positively correlated with FBG and Hcy (r=0.510, 0.376, all P<0.05). The ROC curve showed that the area under curve (AUC) of PTGS2 and CHI3L1 in predicting cognitive impairment was 0.819 and 0.829, respectively. The AUC of the combined prediction of cognitive impairment was 0.902, which was obviously higher than that of the independent prediction of the two (Z =2.089, 2.293; P=0.037, 0.021), with sensitivity and specificity of 77.78% and 98.33%, respectively. Conclusion　PTGS2 and CHI3L1 were highly expressed in the serum of patients with cognitive impairment of cerebrovascular disease, indicating that both were related to cognitive impairment of patients with cerebrovascular disease.

参考文献/References:

[1] 秦琪, 唐毅, 曲怡达, 等. 利用弥散张量成像技术观察小血管病所致非痴呆型血管性认知障碍患者白质结构损害与认知下降的关系[J]. 首都医科大学学报, 2021, 42(3)：373-384. QIN Qi, TANG Yi, QU Yida, et al. Study on the association between white matter connectivity changes and cognitive deficits in vascular cognitive impairment no dementia using diffusion tensor imaging [J]. Journal of Capital Medical University, 2021, 42(3): 373-384.
[2] 张泽阳, 王倩, 陈卓友. 脑小血管病影像学特征及其总体负荷与血管性认知障碍关系的研究进展[J]. 中国脑血管病杂志, 2022, 19(9)：642-647. ZHANG Zeyang, WANG Qian, CHEN Zhuoyou. Research progress on the relationship between imaging characteristics and overall burden of cerebral small vessel disease and vascular cognitive impairment[J].Chinese Journal of Cerebrovascular Diseases, 2022, 19(9): 642-647.
[3] ANAMTHATHMAKULA P, WINUTHAYANON W. Prostaglandin-endoperoxide synthase 2(PTGS2) in the oviduct：roles in fertilization and early embryo development[J]. Endocrinology, 2021, 162(4): 1-14.
[4] L?PEZ D E, BALLAZ S J. The role of brain cyclooxygenase-2 (COX-2) beyond neuroinflammation: neuronal homeostasis in memory and anxiety[J].Molecular Neurobiology, 2020, 57(12): 5167-5176.
[5] TYAGI A, KAMAL M A, PODDAR N K. Integrated pathways of COX-2 and mTOR: roles in cell sensing and Alzheimer's disease [J]. Frontiers in Neuroscience, 2020, 14: 693.
[6] LANANNA B V, MCKEE C A, KING M W, et al. Chi3l1/YKL-40 is controlled by the astrocyte circadian clock and regulates neuroinflammation and Alzheimer’s disease pathogenesis[J]. Science Translational Medicine, 2020, 12(574): eaax3519.
[7] 中国研究型医院学会脑小血管病专业委员会《中国脑小血管病诊治专家共识》编写组. 中国脑小血管病诊治专家共识2021[J]. 中国卒中杂志,2021,16(7):716-726 Cerebral Small Vessel Disease Professional Committee Consensus Writing Group, Chinese Research Hospital Association. Chinese consensus on diagnosis and therapy of cerebral small vessel disease 2021 [J].Chinese Journal of Stroke, 2021, 16(7): 716-726.
[8] 中华医学会老年医学分会老年神经病学组, 脑小血管病认知功能障碍诊疗指南中国撰写专家组, 彭丹涛. 脑小血管病相关认知功能障碍中国诊疗指南(2019)[J]. 中华老年医学杂志,2019,38(4):345-354. Geriatric Neurology Group, Chinese Society of Geriatrics, Clinical Practice Guideline for Cognitive Impairment of Cerebral Small Vessel Disease Writing Group. Clinical practice guideline for cognitive impairment of cerebral small vessel disease of China (2019) [J]. Chinese Journal of Geriatrics, 2019, 38(4): 345-354.
[9] 张春丽, 张颖, 李璐, 等. 脑小血管病患者血清CTRP1 和同型半胱氨酸水平对血管性轻度认知障碍预测价值的研究[J]. 现代检验医学杂志, 2022, 37(1)：182-185, 194. ZHANG Chunli, ZHANG Ying, LI Lu, et al. Study on the predictive value of serum CTRP1 and homocysteine levels in patients with cerebral small vessel diseases in vascular mild cognitive impairment[J]. Journal of Modern Laboratory Medicine, 2022, 37(1): 182-185, 194.
[10] 黄刚, 王倩, 杨寻, 等. 血清皮质醇对老年脑小血管病患者认知功能损害的影响[J]. 中国老年学杂志, 2023, 43(2)：273-276. HUANG Gang, WANG Qian, YANG Xun, et al. Effects of serum cortisol on cognitive impairment in elderly patients with small cerebral vascular disease[J].Chinese Journal of Gerontology, 2023, 43(2): 273-276.
[11] 赵振华, 潘楚锥, 程琼. 血清25 羟基维生素D 与脑小血管病的相关性分析[J]. 福建医科大学学报, 2022, 56(6)：504-509, 515. ZHAO Zhenhua, PAN Chuzhui, CHENG Qiong. Correlation analysis between serum 25 hydroxyvitamin D and cerebral small vascular disease[J]. Journal of Fujian Medical University, 2022, 56(6): 504-509, 515.
[12] CHAUHAN G, ROY K, KUMAR G, et al. Distinct influence of COX-1 and COX-2 on neuroinflammatory response and associated cognitive deficits during high altitude hypoxia [J]. Neuropharmacology, 2019, 146: 138-148.
[13] ZHU Liyuan, ZHANG Yuze, GUO Ziyi, et al. Cardiovascular biology of prostanoids and drug Vascular Biology, 2020, 40(6): 1454-1463.
[14] ZHAO Lei, FANG Jinghuan, ZHOU Muke, et al. Interaction between COX-1 and COX-2 increases susceptibility to ischemic stroke in a Chinese population[J]. BMC Neurology, 2019, 19(1): 291.
[15] WANG Y B, CHEN Z, LI J, et al. Parecoxib improves the cognitive function of POCD rats via attenuating COX-2[J]. European Review for Medical and Pharmacological Sciences, 2019, 23(11): 4971-4979.
[16] ZHU Xinjian, YAO Yuanyuan, YANG Jiurong, et al. COX-2-PGE2 signaling pathway contributes to hippocampal neuronal injury and cognitive impairment in PTZ-kindled epilepsy mice [J]. International Immunopharmacology, 2020, 87: 106801.
[17] IADECOLA C, GOTTESMAN R F. Neurovascular and cognitive dysfunction in hypertension[J]. Circulation Research, 2019, 124(7): 1025-1044.
[18] MAVROUDIS I, CHOWDHURY R, PETRIDIS F, et al. YKL-40 as a potential biomarker for the differential diagnosis of alzheimer's disease[J]. Medicina (Kaunas, Lithuania), 2021, 58(1): 60.
[19] NORDENGEN K, KIRSEBOM B E, HENJUM K, et al. Glial activation and inflammation along the Alzheimer's disease continuum[J]. Journal of Neuroinflammation, 2019, 16(1): 46.
[20] VILLAR-PIQU? A, SCHMITZ M, HERMANN P, et al. Plasma YKL-40 in the spectrum of neurodegenerative dementia[J]. Journal of Neuroinflammation, 2019, 16(1): 145.
[21] 田婧, 白永杰, 尤爱民. 血清Hcy, SAA 和MCP-1 在脑梗死后血管性认知功能障碍患者血清中的表达及意义[J]. 广东医学, 2021, 42(7)：810-813. TIAN Jing, BAI Yongjie, YOU Aimin. The expression and clinical value of serum Hcy,SAA and MCP-1 in vascular cognitive dysfunction after cerebral infarction[J]. Guangdong Medical Journal, 2021, 42(7): 810-813.

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备注/Memo

备注/Memo:
基金项目： 成都市科技项目 (2019-YF09-00120-SN）：基于信息技术的老年痴呆全方位健康管理研究及应用示范；四川省卫生健康委员会科研课题 (19PJ169）：非心源性缺血性脑血管病患者急性期的血压管理与卒中后认知功能障碍相关性的中长期随访研究。
作者简介：曹娜（1990-），女，硕士，主治医师，研究方向：认知障碍，脑血管病，E-mail：550473658@qq.com。
通讯作者：刘艳（1967-），女，硕士，主任医师，研究方向：认知障碍，E-mail：408521577@qq.com。
更新日期/Last Update: 2024-01-15