脑小血管病患者运动障碍与血清IMA LP-PLA2 BDNF水平的相关性研究Correlation between dyskinesia and serum IMA,Lp-PLA2,BDNF levels in patients with cerebral small vessel disease
王天舒;景黎君;滕军放;牛瑞娜;
摘要(Abstract):
目的分析脑小血管病(CSVD)患者运动障碍与血清缺血修饰清蛋白(IMA)、脂蛋白磷脂酶A2(Lp-PLA2)、脑源性神经营养因子(BDNF)的相关性。方法选取郑州大学第一附属医院2019-01—2020-01收治的CSVD患者82例,纳入脑血管病组,另选取同期体检健康者80例为对照组,比较2组血清IMA、Lp-PLA2、BDNF水平。脑血管病组根据有无发生运动障碍分为运动障碍组与非运动障碍组,比较2组血清IMA、Lp-PLA2、BDNF水平及其他可能影响运动功能的因素。采用Logistic回归分析明确CSVD患者运动障碍的独立影响因素,Pearson相关性分析法评价CSVD患者运动障碍简式Fugl-Meyer(FM)运动功能评定量表评分与血清IMA、Lp-PLA2、BDNF水平的相关性。结果脑血管病组血清IMA、Lp-PLA2水平高于对照组,血清BDNF水平低于对照组,差异有统计学意义(P<0.05)。运动障碍组颈动脉粥样硬化占比及血清IMA、Lp-PLA2、Hcy水平高于非运动障碍组,血清BDNF水平低于非运动障碍组,差异有统计学意义(P<0.05)。Logistic回归分析证实颈动脉粥样硬化、血清IMA、Lp-PLA2、BDNF、Hcy水平均是CSVD患者发生运动障碍的独立影响因素(P<0.05)。Pearson相关性分析提示FM评分与血清IMA、Lp-PLA2呈负相关(r=-0.756、-0.670,P<0.05),与血清BDNF水平呈正相关(r=0.602,P<0.05)。结论 CSVD患者血清IMA、Lp-PLA2、BDNF水平异常,且是CSVD患发生运动障碍的独立影响因素,FM量表评分与血清IMA、Lp-PLA2水平呈正相关,与BDNF水平呈负相关。
关键词(KeyWords): 脑小血管病;运动障碍;缺血修饰清蛋白;脂蛋白磷脂酶A2;脑源性神经营养因子
基金项目(Foundation): 国家自然科学基金(编号:81671267)
作者(Authors): 王天舒;景黎君;滕军放;牛瑞娜;
参考文献(References):
- [1]CHEN X,WANG J,SHAN Y,et al.Cerebral small vessel disease:neuroimaging markers and clinical implication[J].J Neurol,2019,266(10):2347-2362.DOI:10.1007/s00415-018-9077-3.
- [2]TER TELGTE A,VAN LEIJSEN E M C,WIEGERTJESK,et al.Cerebral small vessel disease:from a focal to a global perspective[J].Nat Rev Neurol,2018,14(7):387-398.DOI:10.1038/s41582-018-0014-y.
- [3]LI Q,YANG Y,REIS C,et al.Cerebral Small Vessel Disease[J].Cell Transplant,2018,27(12):1711-1722.DOI:10.1177/0963689718795148.
- [4]邱茜茜,孙巧丽,范波胜.阿司匹林联合氯吡格雷治疗高危非致残性脑血管病的临床研究[J].中国实用神经疾病杂志,2018,21(8):827-829.DOI:10.12083/SYSJ.2018.08.207.
- [5]SURI R,RODRIGUEZ-PORCEL F,DONOHUE K,et al.Post-stroke Movement Disorders:The Clinical,Neuroanatomic,and Demographic Portrait of 284 Published Cases[J].J Stroke Cerebrovasc Dis,2018,27(9):2388-2397.DOI:10.1016/j.jstroke-cerebrovasdis.2018.04.028.
- [6]EASTABROOK G,AKSOY T,BEDELL S,et al.Preeclampsia biomarkers:An assessment of maternal cardiometabolic health[J].Pregnancy Hypertens,2018,13:204-213.DOI:10.1016/j.preghy.2018.06.005.
- [7]OMMA A,COLAK S,CAN SANDIKCI S,et al.Serum neopterin and ischemia modified albumin levels are associated with the disease activity of adult immunoglobulin Avasculitis(Henoch-Schonlein purpura)[J].Int J Rheum Dis,2019,22(10):1920-1925.DOI:10.1111/1756-185X.13673.
- [8]张翼,廖远高.急性脑梗死患者血清脂蛋白相关磷脂酶A2与颅内动脉狭窄的关系研究[J].中国实用神经疾病杂志,2018,21(15):1712-1717.DOI:10.12083/SYSJ.2018.15.394.
- [9]MATSUMOTO J,TAKADA S,KINUGAWA S,et al.Brain-Derived Neurotrophic Factor Improves Limited Exercise Capacity in Mice With Heart Failure[J].Circulation,2018,138(18):2064-2066.DOI:10.1161/CIRCU-LATIONAHA.118.035212.
- [10]WARDLAW J M,SMITH E E,BIESSELS G J,et al.Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration[J].Lancet Neurol,2013,12(8):822-838.DOI:10.1016/S1474-4422(13)70124-8.
- [11]OVEISGHARAN S,ORGANJI H,GHORBANI A.Enhancement of Motor Recovery through Left Dorsolateral Prefrontal Cortex Stimulation after Acute Ischemic Stroke[J].J Stroke Cerebrovasc Dis,2018,27(1):185-191.DOI:10.1016/j.jstrokecerebrovasdis.2017.08.026.
- [12]ALLOUBANI A,SALEH A,ABDELHAFIZ I.Hypertension and diabetes mellitus as a predictive risk factors for stroke[J].Diabetes Metab Syndr,2018,12(4):577-584.DOI:10.1016/j.dsx.2018.03.009.
- [13]MOCHIZUKI T,IKARI K,YANO K,et al.Five-year incidence of common comorbidities,such as hypertension,dyslipidemia,diabetes mellitus,cardiovascular disease,cerebrovascular disease and cancer,in older Japanese patients with rheumatoid arthritis[J].Geriatr Gerontol Int,2019,19(7):577-581.DOI:10.1111/ggi.13664.
- [14]SMITH E E,BEAUDIN A E.New insights into cerebral small vessel disease and vascular cognitive impairment from MRI[J].Curr Opin Neurol,2018,31(1):36-43.DOI:10.1097/WCO.0000000000000513.
- [15]石伟纲,薛文俊,杜迎春.非痴呆型脑小血管病患者血清Hcy TGF-β1及BDNF表达与认知功能障碍的关系[J].中国实用神经疾病杂志,2020,23(13):1155-1159.DOI:10.12083/SYSJ.2020.13.262.
- [16]席尚媛,刘波.遗传性脑小血管病的研究进展[J].中国实用神经疾病杂志,2020,23(2):176-180.DOI:10.12083/SYSJ.2020.02.152.
- [17]DEMIR M T,BAYDIN A,AMANVERMEZ R,et al.Comparison of pentraxin-3 and ischemia-modified albumin with troponin in early diagnosis of acute coronary syndrome[J].Bratisl Lek Listy,2018,119 (8):509-512.DOI:10.4149/BLL_2018_093.
- [18]DEMIRTAS A O,KARABAG T,DEMIRTAS D.Ischemic Modified Albumin Predicts Critical Coronary Artery Disease in Unstable Angina Pectoris and Non-ST-Elevation Myocardial Infarction[J].J Clin Med Res,2018,10 (7):570-575.DOI:10.14740/jocmr3417w.
- [19]USLU A U,KUCUK A,BALTA S,et al.The relation between ischemia modified albumin levels and carotid intima media thickness in patients with rheumatoid arthritis[J].Int J Rheum Dis,2019,22(1):32-37.
- [20]ALKURAISHY H M,AL-GAREEB A I,WAHEED H J.Lipoprotein-Associated Phospholipase A2 is Linked with Poor Cardio-Metabolic Profile in Patients with Ischemic Stroke:A Study of Effects of Statins[J].J Neurosci Rural Pract,2018,9(4):496-503.DOI:10.4103/jnrp.jnrp_97_18.
- [21]MENON B,RAMALINGAM K,KRISHNA V.Study of Ischemia Modified Albumin as a Biomarker in Acute Ischaemic Stroke[J].Ann Neurosci,2018,25(4):187-190.DOI:10.1159/000488188.
- [22]HERIANSYAH T,NAFISATUZZAMRUDAH N,AINI FN,et al.Reduction in vasa vasorum angiogenesis by Lp-PLA2 selective inhibitor through the HIF-1αand VEGF expression under dyslipidemic conditions in atherosclerosis pathogenesis[J].Cardiovasc Hematol Agents Med Chem,2018,16(2):114-119.DOI:10.2174/1871525716666181105151429.
- [23]COVERDALE J P C,KATUNDU K G H,SOBCZAK AI S,et al.Ischemia-modified albumin:Crosstalk between fatty acid and cobalt binding[J].Prostaglandins Leukot Essent Fatty Acids,2018,135:147-157.DOI:10.1016/j.plefa.2018.07.014.
- [24]CHEN A D,WANG C L,QIN Y,et al.The effect of Danshen extract on lipoprotein-associated phospholipase A2 levels in patients with stable angina pectoris:study protocol for a randomized controlled trial-the DOLPHIN study[J].Trials,2017,18(1):606.DOI:10.1186/s13063-017-2336-2.
- [25]ALKURAISHY H M,AL-GAREEB A I,WAHEED H J.Lipoprotein-Associated Phospholipase A2 is Linked with Poor Cardio-Metabolic Profile in Patients with Ischemic Stroke:A Study of Effects of Statins[J].J Neurosci Rural Pract,2018,9(4):496-503.DOI:10.4103/jnrp.jnrp_97_18.
- [26]HASSAN T M,YARUBE I U.Peripheral brain-derived neurotrophic factor is reduced in stroke survivors with cognitive impairment[J].Pathophysiology,2018,25(4):405-410.DOI:10.1016/j.pathophys.2018.08.003.
- [27]YILMAZ A B,GOKHAN S,SENER A,et al.Analysis of Neutrophil/Lymphocyte ratio and Thiol/Disulfide homeostasis parameters in patients admitted to the emergency department with ischemic stroke[J].Pak J Med Sci,2018,34(6):1418-1423.DOI:10.12669/pjms.346.16242.
- [28]JENA I,NAYAK S R,BEHERA S,et al.Evaluation of ischemia-modified albumin,oxidative stress,and antioxidant status in acute ischemic stroke patients[J].J Nat Sci Biol Med,2017,8(1):110-113.DOI:10.4103/0976-9668.198346.
- [29]WANG Y,ZHOU B,ZHOU P,et al.Association of lipoprotein-associated phospholipase A2 mass with asymptomatic cerebral artery stenosis[J].J Cell Mol Med,2018,22(4):2329-2336.DOI:10.1111/jcmm.13521.
- [30]LU X,XU X,ZHANG Y,et al.Elevated inflammatory Lp-PLA2 and IL-6 link e-waste Pb toxicity to cardiovascular risk factors in preschool children[J].Environ Pollut,2018,234:601-609.DOI:10.1016/j.envpol.2017.11.094.
- [31]GüNG?R Z B,TüTEN A,EKMEK?I H,et al.Possible effects of lipoprotein-associated phospholipase A2 single-nucleotide polymorphisms on cardiovascular risk in patients with preeclampsia[J].J Matern Fetal Neonatal Med,2018,31(23):3119-3127.DOI:10.1080/14767058.2017.1365125.
- [32]KEEFE K M,SHEIKH I S,SMITH G M.Targeting neurotrophins to specific populations of neurons:NGF,BDNF,and NT-3 and their relevance for treatment of ppinal cord injury[J].Int J Mol Sci,2017,18(3):548.DOI:10.3390/ijms18030548.
- [33]YING X,XIE Q,YU X,et al.Water treadmill training protects the integrity of the blood-spinal cord barrier following SCI via the BDNF/Trk B-CREB signalling pathway[J].Neurochem Int,2020,143:104945.DOI:10.1016/j.neuint.2020.104945.
- [34]XUE M,SUN Y L,XIA Y Y,et al.Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDRNeurons in Spared Nerve Injury Rats[J].Int J Mol Sci,2020,21(18):6524.DOI:10.3390/ijms21186524.
- [35]Ghorbani M,Shahabi P,Karimi P,et al.Impacts of epidural electrical stimulation on Wnt signaling,FAAH,and BDNF following thoracic spinal cord injury in rat[J].J Cell Physiol,2020,235(12):9795-9805.DOI:10.1002/jcp.29793.
- [36]ZAREI M,SABETKASAEI M,MOINI-ZANJANI T.Effect of Paroxetine on the Neuropathic Pain:A Molecular Study[J].Iran Biomed J,2020,24(5):306-313.DOI:10.29252/ibj.24.5.301.
- [37]LI Y,WANG H,DING X,et al.Human Brain-Derived Neurotrophic Factor Gene-Modified Bone Marrow Mesenchymal Stem Cells Combined With Erythropoietin Can Improve Acute Spinal Cord Injury[J].Dose Response,2020,18 (1):1559325820910930.DOI:10.1177/1559325820910930.
- [38]BAHARVAND Z,NABIUNI M,TAHMASEB M,et al.Investigating the synergic effects of valproic acid and crocin on BDNF and GDNF expression in epidermal neural crest stem cells[J].Acta Neurobiol Exp(Wars),2020,80(1):38-46.
- [39]JI W C,LI M,JIANG W T,et al.Protective effect of brain-derived neurotrophic factor and neurotrophin-3overexpression by adipose-derived stem cells combined with silk fibroin/chitosan scaffold in spinal cord injury[J].Neurol Res,2020,42(5):361-371.DOI:10.1080/01616412.2020.1735819.
- [40]MATSUDA M,KANNO H,SUGAYA T,et al.Low-energy extracorporeal shock wave therapy promotes BDNFexpression and improves functional recovery after spinal cord injury in rats[J].Exp Neurol,2020,328:113251.DOI:10.1016/j.expneurol.2020.113251.