[1]李　璐a,张　颖b,张春丽,等.脑小血管病患者外周血Hcy，VILIP-1和UA水平与病情严重程度及认知障碍的相关性研究[J].现代检验医学杂志,2022,37(02):173-178.[doi:10.3969/j.issn.1671-7414.2022.02.035]
　LI Lua,ZHANG Yingb,ZHANG Chun-li,et al.Analysis of the Correlation between Peripheral Blood Hcy, VILIP-1, UA and the Severity of Patients with Cerebral Small Vessel Disease and Cognitive Impairment[J].Journal of Modern Laboratory Medicine,2022,37(02):173-178.[doi:10.3969/j.issn.1671-7414.2022.02.035]
点击复制

脑小血管病患者外周血Hcy，VILIP-1和UA水平与病情严重程度及认知障碍的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年02期
页码:
173-178
栏目:
检验与临床
出版日期:
2022-03-15

文章信息/Info

Title:
Analysis of the Correlation between Peripheral Blood Hcy, VILIP-1, UA and the Severity of Patients with Cerebral Small Vessel Disease and Cognitive Impairment
文章编号:
1671-7414（2022）02-173-06
作者:
李　璐1a; 张　颖1b; 张春丽2; 赵殿兰1b; 刘亚静1b; 王　辉1c; 张春和1a
（1. 沧州市人民医院医专院区a. 医学检验中心;b 神内五区;c. 急诊科，河北沧州 061000；2. 沧州市人民医院本部院区神内三区, 河北沧州 061000）
Author(s):
LI Lu1a; ZHANG Ying1b; ZHANG Chun-li2;  ZHAO Dian-lan1b;  LIU Ya-jing1b;  WANG Hui1c;  ZHANG Chun-he1a
（1a.Department of Medical Laboratory; 1b.the Fifth Ward of Department of Neurology;1c.Department of Emergency,Medical College District of Cangzhou People’s Hospital,Hebei Cangzhou 061000,China;2.the Third Ward of Department Neurology, Headquarters of Cang
关键词:
脑小血管病; 同型半胱氨酸; 视椎蛋白样蛋白1; 尿酸; 认知障碍; 脑动脉搏动指数
分类号:
R743；R446.11
DOI:
10.3969/j.issn.1671-7414.2022.02.035
文献标志码:
A
摘要:
目的　探究外周血同型半胱氨酸（homocysteine，Hcy）、视椎蛋白样蛋白1（visinin-like protein 1，VILIP- 1）、尿酸（uric acid，UA）与脑小血管病（cerebral small vessel disease，CSVD）患者病情程度及认知障碍相关性。方法　选取2017 年6 月～ 2019 年6 月沧州市人民医院医专院区70 例CSVD 患者作为观察组，同期选取30 例健康体检者作为对照组。统计两组及观察组不同神经功能、脑动脉搏动指数（PI）、有无认知障碍、外周血Hcy，VILIP-1 和UA 水平，通过Spearman 和多元线性回归模型分析外周血各指标与病情程度、认知障碍的关系。结果　①观察组外周血VILIP-1（671.05±201.32 pg/ml），Hcy（20.83±6.25 μmol/L），UA（352.21±78.66 μmol/L）高于对照组（475.12±142.54pg/ml，10.05±3.02 μmol/L 和241.25±40.86 μmol/L）, 差异均有统计学意义（t=4.831，8.989，7.698，均P ＜ 0.05）。②观察组PI 重度者外周血UA（449.79±134.94μmol/L），Hcy（30.43±5.89μmol/L）和VILIP-1（876.94±263.08pg/ml）水平高于PI 轻中度者（273.46±82.04μmol/L，360.18±108.05μmol/L；15.33±4.60μmol/L，20.58±6.27μmol/L；502.51±150.75pg/ml，689.84±206.95pg/ml）, 差异均有统计学意义（F=13.545~35.749，均P ＜ 0.05）。观察组NIHSS评分外周血UA（443.70±133.11μmol/L），Hcy（28.33±5.46μmol/L），VILIP-1（941.35±282.41pg/ml）水平高于NIHSS 评分轻中度者（280.25±84.08μmol/L，372.59±111.78μmol/L；16.05±4.82μmol/L，21.42±5.91μmol/L；498.88±149.65pg/ml，692.27±207.61pg/ml），差异均有统计学意义（F=12.544~23.020，均P ＜ 0.05）。③观察组认知障碍者UA（389.96±116.99μmol/L），Hcy（25.66±7.71μmol/L），VILIP-1（811.52±243.56pg/ml）水平高于无认知障碍者（301.88±90.56μmol/L，14.39±4.32μmol/L，483.76±145.13pg/ml），差异均有统计学意义（F=3.424~7.710，均P＜ 0.05）。④外周血Hcy，VILIP-1，UA与PI 呈正相关（r=0.836，0.883，0.728），与NIHSS 评分呈正相关（r=0.665，0.762，0.666），与认知障碍呈负相关（r=-0.591，0.635，0.599）；在控制年龄、性别等其他因素后，外周血Hcy（标准化偏回归系数：0.277，1.122，-0.250），VILIP-1（标准化偏回归系数：0.638，0.304，-0.319），UA（标准化偏回归系数：0.251，0.656，-0.398）与PI 和NIHSS 评分、认知障碍显著相关（均P ＜ 0.05）。结论　CSVD 患者外周血Hcy，VILIP-1 和UA 水平呈高表达，与病情程度、认知障碍密切相关。联合检测其水平变化有助于指导临床治疗。
Abstract:
Objective　To explore the correlation between peripheral blood homocysteine (Hcy), visinin-like protein 1 (VILIP-1), uric acid (UA) and the degree of disease and cognitive impairment in patients with cerebral small vessel disease (CSVD). Methods　From June 2017 to June 2019, 70 patients with CSVD in Cangzhou People’s Hospital, were selected as the observation group, and 30 healthy patients were selected as the control group during the same period. Counting the different disease levels [neural function (NIHSS score), cerebral artery pulsatility index (PI)], peripheral blood Hcy, VILIP-1 and UA levels of cognitive impairment in the two groups and the observation group. Spearman, multiple linear regression model analyzed the relationship between peripheral blood indicators and the degree of illness, cognitive impairment. Results　① The peripheral blood VILIP-1 (671.05±201.32pg/ml), Hcy (20.83±6.25μmol/L) and UA (352.21±78.66μmol/L) of the observation group were higher than those of the control group (475.12±142.54pg/ml, 10.05±3.02 μmol/L, 241.25±40.86μmol/L)，the differences were statistically significant (t=4.831, 8.989, 7.698, all P <0.05). ② The levels of UA (449.79±134.94μmol/L), Hcy (30.43±5.89μmol/L) and VILIP-1 (876.94±263.08 pg/ml) in peripheral blood of patients with severe PI in the observation group were higher than those of patients with mild obseravation moderate PI (273.46±82.04μmol/L, 360.18±108.05μmol/L; 15.33±4.60μmol/L, 20.58±6.27μmol/L;502.51±150.75pg/ml, 689.84±206.95pg/ml), the differences were statistically significant (F=13.545~35.749, all P<0.05), the observation group NIHSS score peripheral blood UA (443.70±133.11μmol/L), Hcy (28.33±5.46μmol/L), VILIP-1 (941.35±282.41pg/ml) level was higher than NIHSS score of mild to moderate (280.25±84.08μmol/L and 372.59±111.78μmol/L, 16.05±4.82μmol/L and 21.42±5.91μmol/L, 498.88±149.65pg/ml and 692.27±207.61pg/ml), the differences were statistically significant(F=12.544~23.020, all P<0.05), respectively. ③ Observation group with cognitive impairment UA (389.96±116.99μmol/L), Hcy (25.66±7.71μmol/L) and VILIP-1 (811.52±243.56pg/ ml) level was higher than those without cognitive impairment (301.88±90.56μmol/L, 14.39±4.32μmol/L, 483.76±145.13 pg/ml), the differences were statistically significant (F=3.424~7.710, all P<0.05). ④ Peripheral blood Hcy, VILIP-1 and UA were positively correlated with PI (r=0.836, 0.883, 0.728), and positively correlated with NIHSS score (r=0.665, 0.762, 0.666), negatively correlated with cognitive impairment (r=-0.591，-0.635，-0.599).After controlling for age, gender, BMI and other factors, peripheral blood Hcy (standardized bias regression coefficient: 0.277, 1.122，-0.250), VILIP-1 (standardized partial regression coefficient: 0.638, 0.304, -0.319), UA (standardized partial regression coefficient: 0.251, 0.656，-0.398) were significantly correlated with PI, NIHSS scores, and cognitive impairment (all P<0.05). Conclusion　The levels of Hcy, VILIP-1 and UA in peripheral blood of patients with csvd were highly expressed, which were closely related to the severity of the disease and cognitive impairment. Combined detection of their levels is helpful to guide clinical treatment.

参考文献/References:

[1] CHEN Xiaodong, WANG Jihui, SHAN Yilong, et al. Cerebral small vessel disease: neuroimaging markers and clinical implication[J]. Journal of Neurology, 2019, 266(10): 2347-2362.
[2] BOUASQUEVISQUE D S, BENAVENTE O R, SHOAMANESH A. Antiplatelet therapy in cerebral small vessel disease [J]. Current Neurology and Neuroscience Reports, 2019, 19(9): 61.
[3] 赵然然, 罗小兰. 同型半胱氨酸水平同缺血性卒中 患者脑小血管病总体负担的相关性研究[J]. 华西医 学, 2019, 34(4):394-399. ZHAO Ranran, LUO Xiaolan. The correlation between homocysteine level and overall burden of cerebral small vessel disease in patients with ischemic stroke [J]. West China Medical Journal,2019,34(4):394-399.
[4] 郝雅娟, 秦小江, 白剑英．脑小血管病患者的相关 血液生化指标分析[J]．中国循证心血管医学杂志, 2019, 11（4）：452-454． HAO Yajuan,QIN Xiaojiang,BAI Jianying,et al. Analysis on related blood biochemical indexes in patients with cerebral small vessel disease [J]. Chinese Journal of Evidence-Bases Cardiovascular Medicine,2019,11(4):452-454.
[5] TANA C, TICINESI A, PRATI B, et al. Uric acid and cognitive function in older individuals [J]. Nutrients, 2018, 10(8): 975.
[6] 王浩, 孙菊光. 血清VILIP-1, NSE 水平与缺血性脑 卒中患者预后的关系[J]. 山东医药,2018,58(41):63- 65. WANG Hao,SUN Juguang.Relationship between serum VILIP-1, NSE levels and prognosis of patients with ischemic stroke[J]. Shandong Medical Journal,2018,58(41):63-65.
[7] 贾建平, 陈生弟, 崔丽英．神经病学[M]．7 版．北京： 人民卫生出版社, 2013：170-208． JIA Jianping, CHEN Shengdi, CUI Liying. Neurology[M].7th Ed.Beijing：People’s Medical Publishing House, 2013:170-208.
[8] 赵静, 常文龙, 宋伟丽, 等．脑小血管病患者认知功 能障碍与脑白质完整性及脑血流灌注的关系[J]．神 经损伤与功能重建,2019,14(9):433-436,453. ZHAO Jing,CHANG Wenlong,SONG Weili,et al. Relationship between cognitive impairment and white matter integrity, cerebral blood flow perfusion in patients with cerebral small vessel disease [J]. Neural Injury and Functional Reconstruction,2019,14(9):433-436,453.
[9] 蔡宾, 张梅, 彭琳, 等. 青年及中老年脑出血血肿扩 大相关危险因素研究[J]. 中国脑血管病杂志, 2019, 16(10):520-525. CAI Bin, ZHANG Mei, PENG Lin,et al. Risk factors for hematoma growth in young and elderly patients with intracerebral hemorrhage [J]. Chinese Journal of Cerebrovascular Diseases,2019,16(10):520-525.
[10] 张金枝, 张潇, 刘真真．脑小血管病患者TCD 检测 脑血流改变与认知功能障碍的相关性研究[J]. 昆明 医科大学学报, 2019, 40(2):106-109. ZHANG Jinzhi, ZHANG Xiao, LIU Zhenzhen,et al. Correlation between cerebral blood flow changes and cognitive dysfunction detected by TCD in patients with cerebral small vessel disease [J]. Journal of Kunming Medical University,2019,40(2):106-109.
[11] LIU Yang, DONG Yanhong, LIU Peiyuan, et al. Hypertension-induced cerebral small vessel disease leading to cognitive impairment[J]. Chinese Medical Journal, 2018, 131(5): 615-619.
[12] WARDLAW J M, SMITH C, DICHGANS M. Small vessel disease: mechanisms and clinical implications[J]. Lancet Neurology, 2019, 18(7): 684-696.
[13] 王雅楠, 范少凯, 牛雪芬, 等. 缺血性脑小血管病患 者一氧化氮、内皮素-1 和尿酸与血管性认知障碍的 相关性[J]. 中国煤炭工业医学杂志, 2019, 22(5):463- 468. WANG Yanan,FAN Shaokai,NIU Xuefen,et al. Association of nitric oxide, endothelin-1 and uric acid with vascular cognitive impairment in patients with ischemic cerebral small vessel diseases [J]. Chinese Journal of Coal Industry Medicine,2019,22(5):463-468.
[14] 李衍芳, 高鸣, 张志超, 等．血尿酸与脑小血管病患 者血管性轻度认知障碍的相关性研究[J]．中国卒中 杂志, 2018, 13(3):237-241. LI Yanfang, GAO Ming,ZHANG Zhichao,et al. Correlation between serum uric acid and vascular mild cognitive impairment in patients with cerebral small vessel disease[J]. Chinese Journal of Stroke,2018,13(3):237-241.
[15] 王学颖, 王洪权, 赵伟丽．脑小血管病患者认知功 能障碍与血尿酸、同型半胱氨酸水平相关性研究[J]. 神经损伤与功能重建, 2019, 14(7):360-361, 373. WANG Xueying,WANG Hongquan,ZHAO Weili,et al.Correlation between cognitive impairment and serum uric acid and homocysteine levels in patients with cerebral small vessel disease[J]. Neural Injury and Functional Reconstruction,2019,14(7):360-361,373.
[16] FAN Huimin, YANG Shuna, LI Yue, et al. Assessment of homocysteine as a diagnostic and early prognostic biomarker for patients with acute lacunar infarction[J]. European Neurology, 2018, 79(1/2): 54-62.
[17] 郭大伟, 白月. 盐酸多奈哌齐片联合养血清脑颗 粒对脑小血管病所致血管性认知功能障碍患者hs- CRP, Hcy, 脑血流灌注和电生理的影响[J]. 现代中西 医结合杂志, 2019, 28(4):352-356, 368． GUO Dawei,BAI Yue. Effects of donepezil hydrochloride tablets combined with Yangxue Qingnao Granule on hs-CRP, Hcy, cerebral perfusion and electrophysiology in patients with vascular cognitive dysfunction caused by cerebral small vessel disease [J]. Modern Journal of Integrated Traditional Chinese and Western Medicine,2019,28(4):352-356,368.
[18] JI Yifan, LI Xiangyu, TENG Zhenjie, et al. Homocysteine is associated with the development of cerebral small vessel disease: retrospective analyses from neuroimaging and cognitive outcomes[J]. Journal of Stroke and Cerebrovascular Diseases, 2020, 29(12): 105393.
[19] 胡康, 张红, 胡蓉．脑小血管病患者发生认知功能 障碍的危险因素与护理干预对策[J]. 实用医院临床 杂志, 2018, 15(3):134-137. HU Kang, ZHANG Hong, HU Rong, et al. Risk factors and nursing intervention of cognitive impairment in patients with cerebral small vessel disease [J]. Practical Journal of Clinical Medicine,2018,15(3):134-137.
[20] 李定安, 陈思宇, 李红妮． 脑卒中患者外周血 CD4+CD25+ 及CD4+CD28-T 细胞的变化及临床意义 [J]．海南医学院学报,2018,24(23):2082-2085,2089. LI Anding,CHEN Siyu,LI Hongni,et al. Changes and clinical significance of CD4+ CD25+ and CD4+ CD28-T cells in peripheral blood of patients with stroke [J]. Journal of Hainan Medical University, 2018,24(23):2082-2085,2089.
[21] 汪东良, 王锦华, 韩威威, 等. 血清学标志物Aβ1- 42, sICAM-1, VILIP-1 对脑梗死后血管性痴呆的预 测价值[J]. 中华全科医学,2019,17(2):225-229. WANG Dongliang,WANG Jinhua,HAN Weiwei,et al. The predictive value of serological markers Aβ1- 42, sICAM-1 and VILIP-1 for vascular dementia after cerebral infarction [J]. Chinese Journal of General Practice,2019,17(2):225-229.
[22] 薛万华, 杨婷. 创伤性颅脑损伤患者血液NSE, hs- CRP 水平和NLR 指标与疾病程度相关价值研究[J]. 现代检验医学杂志, 2018,33 (5): 35-37. XUE Wanhua, YANG Ting. Study on the correlation of disease severity with the serum NSE,sCRP level and NLR in TBI patients [J]. Journal of Modern Laboratory Medicine, 2018,33 (5): 35-37.

相似文献/References:

[1]张 路,王 薇,何法霖,等.国内临床实验室同型半胱氨酸室内质量控制变异系数调查与分析[J].现代检验医学杂志,2015,30(04):132.[doi:10.3969/j.issn.1671-7414.2015.04.040]
　ZHANG Lu,WANG Wei,HE Fa-lin,et al.Investigation and Analysis of the Coefficient of Variation of Internal Quality Control of Homocysteine[J].Journal of Modern Laboratory Medicine,2015,30(02):132.[doi:10.3969/j.issn.1671-7414.2015.04.040]
[2]赵佳a,姚创利a,左林,等.冠心病患者血清同型半胱氨酸对血脂和锰超氧化物歧化酶的影响[J].现代检验医学杂志,2015,30(05):44.[doi:10.3969/j.issn.1671-7414.2015.05.013]
　ZHAO Jiaa,YAO Chuang-lia,ZUO Lin,et al.Effects of Homocysteine on Blood Lipid and Manganese Superoxide Dismutase in Patients with Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2015,30(02):44.[doi:10.3969/j.issn.1671-7414.2015.05.013]
[3]张瑞.脑梗死患者血清同型半胱氨酸、血浆叶酸和维生素B12水平的相关性研究[J].现代检验医学杂志,2015,30(05):118.[doi:10.3969/j.issn.1671-7414.2015.05.036]
　ZHANG Rui.Correlation Study on Homocysteine，Plasma Folate and Vitamin B12 Levels in Serum of Cerebral Infarction Patients[J].Journal of Modern Laboratory Medicine,2015,30(02):118.[doi:10.3969/j.issn.1671-7414.2015.05.036]
[4]李友建,顾桂兰,王志勇,等.同型半胱氨酸、糖化血红蛋白和血脂与后循环缺血的相关性研究[J].现代检验医学杂志,2015,30(02):132.[doi:10.3969/j.issn.1671-7414.2015.02.041]
　LI You-jian,GU Gui-lan,WANG Zhi-yong,et al.Relationship between Homocysteine,Glycosylated Hemoglobin, Lipids and Posterior Circulation Ischemia[J].Journal of Modern Laboratory Medicine,2015,30(02):132.[doi:10.3969/j.issn.1671-7414.2015.02.041]
[5]高 科,陶 娟,范 宁,等.联合检测三种生化指标对糖尿病肾病早期诊断的临床价值分析[J].现代检验医学杂志,2016,31(04):117.[doi:10.3969/j.issn.1671-7414.2016.04.033]
　GAO Ke,TAO Juan,FAN Ning,et al.Analysis of Combined Detection of Three Kinds of Biochemical Indexes of Clinical Value for Early Diagnosis of Diabetic Nephropathy[J].Journal of Modern Laboratory Medicine,2016,31(02):117.[doi:10.3969/j.issn.1671-7414.2016.04.033]
[6]国钰梅,马 龙,潘国涛,等.急性缺血性脑卒中患者同型半胱氨酸水平与出院结局的关联研究[J].现代检验医学杂志,2016,31(05):23.[doi:10.3969/j.issn.1671-7414.2016.05.006]
　GUO Yu-mei,MA Long,PAN Guo-tao,et al.Relationship between Homocysteine Levels in Patients with Acute Ischemic Stroke and Discharged Outcome[J].Journal of Modern Laboratory Medicine,2016,31(02):23.[doi:10.3969/j.issn.1671-7414.2016.05.006]
[7]周萍,肖尧,袁瑞丽,等.血清Hcy和hs-CRP水平检测在AMI早期临床诊断中的临床应用[J].现代检验医学杂志,2016,31(06):79.[doi:10.3969/j.issn.1671-7414.2016.06.022]
　ZHOU Ping,XIAO Yao,YUAN Rui-li,et al.Application Value of Serum Hcy and hs-CRP Levels in Early Diagnosis of AMI[J].Journal of Modern Laboratory Medicine,2016,31(02):79.[doi:10.3969/j.issn.1671-7414.2016.06.022]
[8]范艳平a,易甲其a,吴 敏b.缺血性脑卒中患者血清Hcy和EPO水平的变化及其与颈动脉粥样硬化关系[J].现代检验医学杂志,2017,32(01):80.[doi:10.3969/j.issn.1671-7414.2017.01.022]
　FAN Yan-pinga,YI Jia-qia,WU Minb.Changes of Serum Hcy and EPO Levels in Patients with Ischemic Stroke and Their Relationship with Carotid Artery Atherosclerosis[J].Journal of Modern Laboratory Medicine,2017,32(02):80.[doi:10.3969/j.issn.1671-7414.2017.01.022]
[9]左 林,赵 佳,姜小建,等.缺血性脑血管病患者血清同型半胱氨酸、叶酸和维生素B12水平与头颈部血管狭窄的相关性研究[J].现代检验医学杂志,2017,32(02):23.[doi:10.3969/j.issn.1671-7414.2017.02.006]
　ZUO Lin,ZHAO Jia,JIANG Xiao-jian,et al.Correlation Study between Serum Homocysteine, Folate,Vitamin B12 Levels and Head and Neck Vascular Stenosis in Patients with Ischemic CerebroVascular Disease[J].Journal of Modern Laboratory Medicine,2017,32(02):23.[doi:10.3969/j.issn.1671-7414.2017.02.006]
[10]左 林,赵 佳,姜小建,等.缺血性脑血管病患者血清同型半胱氨酸水平与颈动脉狭窄及斑块稳定性的相关性研究[J].现代检验医学杂志,2017,32(03):11.[doi:10.3969/j.issn.1671-7414.2017.03.003]
　ZUO Lin,ZHAO Jia,JIANG Xiao-jian,et al.Correlation Study between Serum Homocysteine Level and Carotid Artery Stenosis， Plaque Stability in Patients with Ischemic Cerebrovascular Disease[J].Journal of Modern Laboratory Medicine,2017,32(02):11.[doi:10.3969/j.issn.1671-7414.2017.03.003]

备注/Memo

备注/Memo:
基金项目：2020 年度河北省医学科学研究课题计划（20200280）；2016 年沧州市科学技术研究与发展指导计划项目（162302084）。
作者简介：李璐（1989-），女，本科，主管检验师，研究方向：临床医学检验，临床微生物检验，E-mail: wanghhyue@163.com。
更新日期/Last Update: 1900-01-01