ET-1与UA在轻度认知障碍患者中的意义Clinical value of ET-1 and UA measurements in the patients with mild cognitive impairment
罗雅婷,刘雪梅
摘要(Abstract):
目的探析血管内皮素-1(ET-1)与血清尿酸(UA)在轻度认知障碍(MCI)患者中的检测价值。方法分析2013-01—2016-11信阳市中心医院院及信阳市职业技术学院附属医院诊治的74例MCI患者的临床资料。根据MCI患者的临床症状分成A组(单纯记忆障碍,无其他认知障碍,32例)和B组(记忆障碍合并其他认知功能障碍,42例)2组。另外选取同期接受健康体检的76例正常健康者作为本次研究的对照组。比较MCI组与对照组的基线资料、血清UA与ET-1水平,比较A、B 2组患者的血清UA与ET-1水平。多因素Logistic回归分析MCI的危险因子。结果 MCI组与对照组的基线资料无显著性差异(P>0.05)。MCI组患者的血清UA水平明显低于对照组,ET-1水平明显高于对照组(P<0.01);A组患者血清UA明显高于B组(P<0.01),ET-1水平与B组相比差异无统计学意义(P>0.05)。年龄、血压、血糖、UA、ET-1、TC、LDL-C是MCI患者的独立危险因子。结论高ET-1、低UA水平均是MCI患者发病的独立危险因子,检测ET-1与UA水平在MCI患者中具有重要的临床价值。
关键词(KeyWords): 轻度认知障碍;血管内皮素-1;尿酸;记忆障碍;阿尔茨海默病
基金项目(Foundation):
作者(Author): 罗雅婷,刘雪梅
参考文献(References):
- [1] KNOPMAN D S,GOTTESMAN R F,SHARRETT A R,et al.Mild Cognitive Impairment and Dementia Prevalence:The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)[J].Alzheimers Dementia,2016,2:1-11.
- [2] WHITEHEAD L.Psychological Treatments for Depression and Anxiety in Dementia and Mild Cognitive Impairment[J].Issues Ment Health Nurs,2016,37(10):773-774.
- [3] TEN BRINKE L F,BOLANDZADEH N,NAGAMATSU L S,et al.Aerobic exercise increases hippocampal volume in older women with probable mild cognitive impairment:a 6-month randomised controlled trial[J].Br J Sports Med,2015,49(4):248-254.
- [4] ZHANG Y,WANG S,PHILLIPS P,et al.Detection of Alzheimer’s disease and mild cognitive impairment based on structural volumetric MR images using 3D-DWT and WTA-KSVM trained by PSOTVAC[J].Biomedical Signal Processing Control,2015,21:58-73.
- [5] LI H,LI J,LI N,et al.Cognitive intervention for persons with mild cognitive impairment:A meta-analysis[J].Ageing ResRev,2011,10(2):285-296.
- [6] ELLISON J M.Mild Cognitive Impairment[J].CNS Spectrums,2008,13(1):2.
- [7] GOLOB E J,MIRANDA G G,JOHNSON R J K,et al.Sensory cortical interactions in aging,mild cognitive impairment,and Alzheimer’s disease[J].NeurobiolAging,2015,22(5):755-763.
- [8] MUFSON E J,MA S Y,COCHRAN E J,et al.Loss of nucleus basalis neurons containing trkAimmunorea-ctivity in individuals with mild cognitive impairment and early Alzheimer’s disease[J].J Comp Neurol,2015,427(1):19-30.
- [9] WHARTON W,GOLDSTEIN F C,ZHAO L,et al.Modulation of Renin-Angiotensin System May Slow Conversion from Mild Cognitive Impairment to Alzheimer’s Disease[J].J Am Geriatr Soc,2015,63(9):1 749-1 756.
- [10] GAINOTTI G,QUARANTA D,VITA M G,et al.Neuropsychological predictors of conversion from mild cognitive impairment to Alzheimer’s disease[J].JAlzheimers Dis,2014,38(3):481-495.
- [11] WEI R,LI C,FOGELSON N,et al.Prediction of Conversion from Mild Cognitive Impairment to Alzheimer’s Disease Using MRI and Structural Network Features[J].FrontAging Neurosci,2016,8:76.
- [12] LI H,LIU Y,GONG P,et al.Hierarchical interactions model for predicting Mild Cognitive Impairment (MCI) to Alzheimer’s Disease (AD) conversion[J].Plos One,2014,9(1):e82450.
- [13] PETERSEN RC,CARACCIOLO B,BRAYNE C,et al.Mild cognitive impairment:a concept in evolution[J].JIntern Med,2014,275(3):214-228.
- [14] BREITNER J C.Mild cognitive impairment and progression to dementia:new findings[J].Neurology,2014,82(4):34-35.
- [15] CHEATHAM CL,VAZQUEZ-VIDAL I,MEDLIN A,et al.Blueberry Consumption Affects Serum Uric Acid Concentrations in Older Adults in a Sex-Specific Manner[J].Antioxidants (Basel),2016,5(4):pii:E43.
- [16] LI JJ,HUANG YH,LIN YY,et al.The association of uric acid with leukoaraiosis[J].J Int Med Res,2017,45(1):75-81.
- [17] WANG T,SUN Z W,SHAO L Q,et al.Diagnostic Values of Serum Levels of Homocysteine and Uric Acid for Predicting Vascular Mild Cognitive Impairment in Patients with Cerebral Small Vessel Disease[J].Med SciMonit,2017,23:2 217-2 225.
- [18] LIU M,WANG J,ZENG J,et al.Relationship between serum uric acid level and mild cognitive impairment in Chinese community elderly[J].BMC Neurology,2017,17(1):146.
- [19] PELLECCHIA MT,SAVASTANO R,MOCCIA M,et al.Lower serum uric acid is associated with mild cognitive impairment in early Parkinson’s disease:a 4-year follow-up study[J].J Neural Transm (Vienna),2016,123(12):1 399-1 402.
- [20] LINGLINGX,YONGBING L,HUIPING X,et al.Low uric acid is a risk factor in mild cognitive impairment[J].Neuropsychiatr DisTreat,2017,13:2 363-2 367.
- [21] POLIDORI MC,RUGGIERO C,CROCE MF,et al.Association of increased carotid intima-media thickness and lower plasma levels of vitamin C and vitamin E in old age subjects:implications for Alzheimer’s disease[J].J Neural Transm (Vienna),2015,122(4):523-530.
- [22] SCHRAG M,MUELLER C,ZABEL M,et al.Oxidative stress in blood in Alzheimer’s disease and mild cognitive impairment:a meta-analysis[J].Neurobiol Dis,2013,59:100-110.
- [23] HU ZY,RONG G,KUN N,et al.Association between serum uric acid level and cognitive impairment in patients with Parkinson’s disease[J].J International Neurology Neurosurg,2013,40(3):216-219.
- [24] CERVELLATI C,CREMONINI E,BOSI C,et al.Systemic oxidative stress in older patients with mild cognitive impairment or late onset Alzheimer’s disease[J].Curr Alzheimer Res,2013,10(4):365-372.
- [25] CERVELLATI C,ROMANI A,SERIPA D,et al.Oxidative balance,homocysteine,and uric acid levels in older patients with Late Onset Alzheimer’s Disease or Vascular Dementia[J].J NeurolSci,2014,337(1/2):156-161.
- [26] SHARMA M,FITZPATRICK A L,ARNOLD A M,et al.Inflammatory Biomarkers and Cognitive Decline:The Ginkgo Evaluation of Memory Study[J].J Am GeriatrSoc,2016,64(6):1 171-1 177.
- [27] RUIZ A,PESINI P,ESPINOSA A,et al.Blood amyloid beta levels in healthy,mild cognitive impairment and Alzheimer’s disease individuals:replication of diastolic blood pressure correlations and analysis of critical covariates[J].PLoS One,2013,8(11):e81334.
- [28] BLASI F,WEI Y,BALKAYA M,et al.Recognition memory impairments after subcortical white matter stroke in mice[J].Stroke,2014,45(5):1 468-1 473.
- [29] PAGANONI S,ZHANG M,QUIROZ ZA,et al.Uric acid levels predict survival in men with amyotrophic lateral sclerosis[J].J Neurol,2012,259(9):1 923-1 928.
- [30] YAO Q,JIANG G X,ZHOU Z M,et al.Metabolic Syndrome and Mild Cognitive Impairment:A Case-Control Study among Elderly in a Shanghai Suburb[J].J Alzheimers Dis,2016,51(4):1 175-1 182.
- [31] KHAN A A,QUINN T J,HEWITT J,et al.Serum uric acid level and association with cognitive impairment and dementia:systematic review and meta-analysis[J].Age (Dordr),2016,38(1):16.
- [32] BROWN J M,LANSDALL C J,WIGGINS J,et al.The Test Your Memory for Mild Cognitive Impairment (TYM-MCI)[J].J Neurol Neurosurg Psychiatry,2017,88(12):1 045-1 051.
- [33] SCHJ?NNING NIELSEN M,SIMONSEN A H,SIERSMA V,et al.Quantitative Electroencephal-ography Analyzed by Statistical Pattern Recognition as a Diagnostic and Prognostic Tool in Mild Cognitive Impairment:Results from a Nordic Multicenter Cohort Study[J].Dement Geriatr Cogn Dis Extra,2018,8(3):426-438.
- [34] SANFORD A M.Mild Cognitive Impairment[J].Clin Geriatr Med,201,33(3):325-337.
- [35] OISHI A,YAMASAKI T,TSURU A,et al.Decreased Gray Matter Volume of Right Inferior Parietal Lobule Is Associated With Severity of Mental Disorientation in Patients With Mild Cognitive Impairment[J].Front Neurol,2018,9:1 086.
- [36] DEVENNEY K E,SANDERS M L,LAWLOR B,et al.The effects of an extensive exercise programme on the progression of Mild Cognitive Impairment(MCI):study protocol for a randomised controlled trial[J].BMC Geriatr,2017,17(1):75.
- [37] PEI X,LAI S,HE X,et al.Mild cognitive impairment in maintenance hemodialysis patients:a cross-sectional survey and cohort study[J].Clin Interv Aging,2018,14:27-32.
- [38] SRAMEK J J,VEROFF A E,CUTLER N R.Mild cognitive impairment:emerging therapeutics[J].Ann Pharmacother,2000,34(10):1 179-1 188.
- [39] LIN L,XING G,HAN Y.Advances in Resting State Neuroimaging of Mild Cognitive Impairmen[J].Front Psychiatry,2018,9:671.
- [40] LONG Z,HUANG J,LI B,et al.A Comparative Atlas-Based Recognition of Mild Cognitive Impairment With Voxel-Based Morphometry[J].Front Neurosci,2018,12:916.
- [41] MIRANDA D D C,BRUCKI S M D,YASSUDA M S.The Mini-Addenbrooke’s Cognitive Examination (M-ACE) as a brief cognitive screening instrument in Mild Cognitive Impairment and mild Alzheimer’s disease[J].Dement Neuropsychol,2018,12(4):368-373.
- [42] VIVAS A B,YPSILANTI A,LADAS A I,et al.Enhancement of Visuospatial Working Memory by the Differential Outcomes Procedure in Mild Cognitive Impairment and Alzheimer’s Disease[J].Front Aging Neurosci,2018,10:364.
- [43] MCMASTER M,KIM S,CLARE L,et al.Body,Brain,Life for Cognitive Decline (BBL-CD):protocol for a multidomain dementia risk reduction randomized controlled trial for subjective cognitive decline and mild cognitive impairment[J].Clin Interv Aging,2018,13:2 397-2 406.
- [44] SRAMEK J J,VEROFF A E,CUTLER N R.The status of ongoing trials for mild cognitive impairment[J].Expert Opin Investig Drugs,2001,10(4):741-752.
- [45] BARTOS A,FAYETTE D.Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons[J].Dement Geriatr Cogn Disord,2018,46(5-6):335-345.
- [46] MUNRO C A.The concept of mild cognitive impairment:a victim of its ubiquity[J].Int Psychogeriatr,2018,30(10):1 423-1 425.
- [47] DURO D,FREITAS S,TáBUAS-PEREIRA M,et al.Discriminative capacity and construct validity of the Clock Drawing Test in Mild Cognitive Impairment and Alzheimer’s disease[J].Clin Neuropsychol,2018,13:1-17.
- [48] CELSIS P.Age-related cognitive decline,mild cognitive impairment or preclinical Alzheimer’s disease?[J].Ann Med,2000,32(1):6-14
- [49] LEE G J,BANG H J,LEE K M,et al..A comparison of the effects between 2 computerized cognitive training programs,Bettercog and COMCOG,on elderly patients with MCI and mild dementia:A single-blind randomized controlled study[J].Medicine (Baltimore),2018,97(45):e13007.
- [50] MORRIS J C,STORANDT M,MILLER J P,et al.Mild cognitive impairment represents early-stage Alzheimer disease[J].Arch Neurol,2001,58(3):397-405.
- [51] HUANG C,WAHLUND L,DIERKS T,et al.Discrimination of Alzheimer’s disease and mild cognitive impairment by equivalent EEG sources:a cross-sectional and longitudinal study[J].Clin Neurophysiol,2000,111(11):1 961-1 967.
- [52] WANG Z,ZHENG Y,ZHU D C,et al.Classification of Alzheimer’s Disease,Mild Cognitive Impairment and Normal Control Subjects Using Resting-State fMRI Based Network Connectivity Analysis[J].IEEE J Transl Eng Health Med,2018,6:1801009.
- [53] ASSAF G,TANIELIAN M.Mild cognitive impairment in primary care:a clinical review[J].Postgrad Med J,2018,94(1117):647-652.
- [54] WONG C G,THOMAS K R,EDMONDS E C,et al.Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old[J].Dement Geriatr Cogn Disord,2018,46(5-6):253-265.
- [55] CRUZ GONZALEZ P,FONG K N K,CHUNG R C K,et al.Can Transcranial Direct-Current Stimulation Alone or Combined With Cognitive Training Be Used as a Clinical Intervention to Improve Cognitive Functioning in Persons With Mild Cognitive Impairment and Dementia?A Systematic Review and Meta-Analysis[J].Front Hum Neurosci,2018,12:416.
- [56] TANGALOS E G,PETERSEN R C.Mild Cognitive Impairment in Geriatrics[J].Clin Geriatr Med,2018,34(4):563-589.
- [57] MRAKIC-SPOSTA S,DI SANTO S G,FRANCHINI F,et al.Effects of Combined Physical and Cognitive Virtual Reality-Based Training on Cognitive Impairment and Oxidative Stress in MCI Patients:A Pilot Study[J].Front Aging Neurosci,2018,10:282.
- [58] KANTARCI K,JACK C R J R,XU Y C,et al.Mild cognitive impairment and Alzheimer disease:regional diffusivity of water[J].Radiology,2001,219(1):101-107.
- [59] ZHANG L,ZHAO Y,SHEN C,et al.Can Long-Term Regular Practice of Physical Exercises Including Taichi Improve Finger Tapping of Patients Presenting With Mild Cognitive Impairment?[J].Front Physiol,2018,9:1 396.
- [60] HOLMER J,ERIKSDOTTER M,SCHULTZBERG M,et al.Association between periodontitis and risk of Alzheimer’s disease,mild cognitive impairment and subjective cognitive decline:A case-control study[J].J Clin Periodontol,2018,45(11):1 287-1 298.
- [61] MCCADE D L,GUASTELLA A J,CHEN N T M,et al.Visual Processing of Emotional Faces is Preserved in Mild Cognitive Impairment[J].J Alzheimers Dis,2018,66(1):397-405.
- [62] EDMONDS E C,WEIGAND A J,THOMAS K R,et al.Increasing Inaccuracy of Self-Reported Subjective Cognitive Complaints Over 24 Months in Empirically Derived Subtypes of Mild Cognitive Impairment[J].J Int Neuropsychol Soc,2018,24(8):842-853.
- [63] INVITTO S,PIRAINO G,CICCARESE V,et al.Potential Role of OERP as Early Marker of Mild Cognitive Impairment[J].Front Aging Neurosci,2018,10:272.
- [64] MATEOS R.Mild cognitive impairment:some steps forward.Int Psychogeriatr[J].2018,30(10):1 427-1 429.
- [65] 郗欧,焦富英,马进,等.头皮针联合康复训练对脑卒中后轻度认知障碍患者脑血流动力学及血管内皮功能的影响[J].世界中医药,2019,14(2):477-480.
- [66] 王丽娜,刘芳.阿托伐他汀结合针刺对脑卒中后轻度认知障碍患者的效果[J].广东医学,2018,39(23):3 557-3 561.
- [67] 董彬,薛承景,赵雅宁,等.阻塞性睡眠呼吸暂停低通气综合征合并高血压性脑出血患者血浆内皮素1和同型半胱氨酸水平及其对认知功能的影响研究[J].中国全科医学,2017,20(21):2 578-2 582.
- [68] 张宪忠,高磊,焦静,等.复方苁蓉益智胶囊对中风后轻度认知障碍患者脑血流及血管内皮功能的影响研究[J].世界中西医结合杂志,2015(4):533-536.
- [69] 游彦慧.西宁地区缺血性脑小血管病轻度认知障碍影响因素分析[D].西宁:青海大学,2016.
- [70] 申潇竹,白丽娟,王建枝,等.老年轻度认知障碍患者血清氧化应激状态与幽门螺杆菌感染的关系[J].中华老年医学杂志,2009,28(12):969-971.