血清甘丙肽、碱性磷酸酶、S100β水平与老年急性脑梗死伴脑微出血病人认知功能障碍的关系

doi:10.3969/j.issn.1003-9198.2025.05.014

摘要/Abstract

摘要： 目的探讨血清甘丙肽、碱性磷酸酶(ALP)、S100β水平与老年急性脑梗死(ACI)伴脑微出血(CMBs)病人认知功能障碍的关系。方法选取2020年6月至2024年6月沧州市人民医院神经内科收治的110例伴CMBs的ACI病人(CMBs组)和136例不伴CMBs的ACI病人(非CMBs组),根据是否存在认知功能障碍将CMBs病人分为认知障碍组(47例)和非认知障碍组(63例)。采用对硝基苯磷酸盐测定法检测血清ALP水平,酶联免疫吸附试验检测血清甘丙肽、S100β水平。采用Pearson相关系数评估甘丙肽、ALP、S100β水平与认知功能评分的相关性,采用多因素logistic回归分析伴CMBs的ACI病人认知功能障碍的影响因素,采用ROC曲线分析甘丙肽、ALP、S100β诊断伴CMBs的ACI病人认知功能障碍的价值。结果 CMBs组血清甘丙肽、ALP、S100β水平均高于非CMBs组(P＜0.01),认知障碍组血清甘丙肽、ALP、S100β水平高于非认知障碍组(P＜0.01)。认知障碍组血清甘丙肽、ALP、S100β水平与MoCA评分、MMSE评分均呈负相关(P＜0.01)。高NIHSS评分、高水平甘丙肽、高水平ALP、高水平S100β是伴CMBs的ACI病人认知功能障碍的危险因素。甘丙肽、ALP、S100β诊断伴CMBs的ACI病人认知功能障碍的曲线下面积分别为0.802、0.773、0.762,联合诊断曲线下面积为0.948,高于单独指标的诊断价值(均P＜0.05)。结论伴CMBs的ACI病人血清甘丙肽、ALP、S100β水平显著增高,并与认知功能障碍有关,三者联合在伴CMBs的ACI病人认知功能障碍诊断中具有较高的价值。

关键词: 急性脑梗死, 脑微出血, 认知功能障碍, 甘丙肽, 碱性磷酸酶, S100β

Abstract: Objective To investigate the relationship between serum levels of galanin, alkaline phosphatase (ALP), S100β and cognitive dysfunction in the elderly patients with acute cerebral infarction (ACI) combineed with cerebral microbleeds (CMBs). Methods A total of 110 ACI patients with CMBs (CMBs group) and 136 ACI patients without CMBs (non-CMBs group) admitted to Department of Neurology of Cangzhou People’s Hospital from June 2020 to June 2024 were enrolled in this study. The ACI patients with CMBs were divided into cognitive impairment group (47 cases) and non-cognitive impairment group (63 cases) according to the presence of cognitive dysfunction. The level of serum ALP was measured by the p-nitrophenyl phosphate assay, and the serum levels of galanin and S100β were determined by enzyme-linked immunosorbent assay.The correlation between serum levels of galanin, ALP, S100β levels and cognitive function score were evaluated by Pearson coefficients, and the influencing factors of cognitive dysfunction in ACI patients with CMBs were analyzed by multivariate logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of galanin, ALP and S100β for cognitive dysfunction in ACI patients with CMBs. Results The levels of galanin, ALP and S100β in CMBs group were higher than those in non-CMBs group (P<0.01). The levels of galanin, ALP and S100β in cognitive impairment group were higher than those in non-cognitive impairment group (P<0.01). The serum levels of galanin, ALP, S100β were negatively correlated with the scores of Montreal Cognitive Assessment and Mini-Mental State Examination in the cognitive impairment group (P<0.01). High score of National Institutes of Health Stroke Scale, and high levels of galanin, ALP and S100β were the risk factors for cognitive dysfunction in ACI patients with CMBs. The area under the curve (AUC) of galanin, ALP and S100β in diagnosing cognitive dysfunction in ACI patients with CMBs was 0.802, 0.773 and 0.762, respectively, and the AUC of combination of the three indicators was 0.948, which was higher than that of the single indicator (all P<0.05). Conclusions Serum levels of galanin, ALP and S100β are significantly increased in ACI patients with CMBs, and are related to cognitive dysfunction. The combination of the three indicators has high value in the diagnosis of cognitive dysfunction in ACI patients with CMBs.

Key words: acute cerebral infarction, cerebral microbleed, cognitive dysfunction, galanin, alkaline phosphatase, S100β

中图分类号:

R 749.3

冉芳, 田烜, 刘峰, 谢璐璐, 张健, 陈林云. 血清甘丙肽、碱性磷酸酶、S100β水平与老年急性脑梗死伴脑微出血病人认知功能障碍的关系[J]. 实用老年医学, 2025, 39(5): 502-507.

RAN Fang, TIAN Xuan, LIU Feng, XIE Lulu, ZHANG Jian, CHEN Linyun. Relationship between serum levels of galanin, alkaline phosphatase, S100β and cognitive dysfunction in elderly patients with acute cerebral infarction combined with cerebral microbleeds[J]. Practical Geriatrics, 2025, 39(5): 502-507.

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