切换至 "中华医学电子期刊资源库"
高级检索
中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2019, Vol. 09 ›› Issue (03) : 163 -167. doi: 10.3877/cma.j.issn.2095-123X.2019.03.009

所属专题： 文献；

临床研究

急性脑梗死患者血清BDNF、IL-6和TNF-α含量与血管性认知障碍关系的临床分析
欧春影1, 李传玲1,†(), 安晓雷1, 李晓宾1, 郭靖1, 许可1   
  1. 1. 221000　徐州市中心医院神经内科
  • 收稿日期:2019-05-06 出版日期:2019-06-15
  • 通信作者: 李传玲
  • 基金资助:
    江苏省科技厅临床医学专项课题(BL2014028)

Clinical analysis of the relationship between serum BDNF, IL-6, TNF-α levels and vascular cognitive impairment after acute cerebral infarction

Chunying Ou1, Chuanling Li1,†(), Xiaolei An1, Xiaobin Li1, Jing Guo1, Ke Xu1   

  1. 1. Department of Neurology, Xuzhou Central Hospital, Xuzhou 221000, China
  • Received:2019-05-06 Published:2019-06-15
  • Corresponding author: Chuanling Li
  • About author:
    Corresponding author: Li Chuanling, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

欧春影, 李传玲, 安晓雷, 李晓宾, 郭靖, 许可. 急性脑梗死患者血清BDNF、IL-6和TNF-α含量与血管性认知障碍关系的临床分析[J]. 中华脑科疾病与康复杂志(电子版), 2019, 09(03): 163-167.

Chunying Ou, Chuanling Li, Xiaolei An, Xiaobin Li, Jing Guo, Ke Xu. Clinical analysis of the relationship between serum BDNF, IL-6, TNF-α levels and vascular cognitive impairment after acute cerebral infarction[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(03): 163-167.

目的

探讨急性脑梗死血清脑源性神经营养因子（BDNF）、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）含量与血管性认知障碍（VCI）关系的临床分析，为早期预防VCI提供一定的理论依据。

方法

收集徐州市中心医院神经内科自2016年7月至2017年1月收治的急性脑梗死患者142例为研究组，选择同期无器质性病变的成人血清40例作为对照组，在脑梗死后急性期（0~7 d）、恢复期（16~30 d）及脑梗死后3个月进行血清BDNF、IL-6、TNF-α的测定，随访3个月，根据简易精神状态检查表和中文版蒙特利认知评分量表，将142例急性脑梗死患者根据预后分为2组，非认知障碍组和认知障碍组；比较2组BDNF、IL-6、TNF-α的差异，评估血清BDNF、IL-6、TNF-α含量与VCI关系。

结果

研究组在急性期、恢复期的BDNF、IL-6、TNF-α均高于对照组，差异均具有统计学意义（P<0.05）；研究组在脑梗死后3个月的BDNF、TNF-α高于对照组，差异无统计学意义（P>0.05）；研究组在脑梗死后3个月的IL-6高于对照组，差异具有统计学意义（P<0.05）。观察3个月，142例急性脑梗死患者，29例发生VCI，为认知障碍组；113例没有VCI，为非认知障碍组。非认知障碍组在急性期、恢复期、脑梗死后3个月的BDNF高于认知障碍组，特别是恢复期，BDNF含量明显增高，差异具有统计学意义（t=2.405，P=0.017）。非认知障碍组在急性期、恢复期、脑梗死后3个月的IL-6、TNF-α均低于认知障碍组，差异均具有统计学意义（P<0.05）。

结论

BDNF、IL-6、TNF-α参与脑梗死后VCI的病理过程，BDNF在脑梗死后VCI有保护作用；IL-6、TNF-α在脑梗死后VCI可能存在负作用。

关键词: 脑梗死, 血管性认知障碍, 急性期, 脑源性神经营养因子, 白细胞介素-6, 肿瘤坏死因子α
Objective

To investigate the relationship between serum levels of brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) and vascular cognitive impairment (VCI) in patients with acute cerebral infarction, and to provide some theoretical basis for early prevention of VCI.

Methods

One hundred and forty-two patients with acute infarction who were hospitalized in Department of Neurology of Xuzhou Central Hoapital from July 2016 to January 2017 were included in the research group, and 40 adults with no organic lesions were included in the control group. Serum levels of BDNF, IL-6, TNF-α were measured in acute phase (0-7 d), recovery period (16-30 d) and 3 months after cerebral infarction. Followed-up for 3 months, according to the mini-mental state examination and the Chinese version of the Monterey cognitive rating scale, 142 patients with acute cerebral infarction were divided into two groups: non-cognitive impairment group and cognitive impairment group; the difference of BDNF, IL-6 and TNF-α was compared between the two groups to evaluate the relationship between the content of BDNF, IL-6 and TNF-α with VCI.

Results

Compared with the control group, the levels of serum BDNF, IL-6 and TNF-α in the acute phase, recovery period and 3 months after acute cerebral infarction were higher than those in the control group; the difference was statistically significant (P<0.05). The BDNF and TNF-α level in the phase of 3 months after acute cerebral infarction was higher than that in the control group, but the difference was not statistically significant (P>0.05). IL-6 of 3 months after acute cerebral infarction was higher than that in the control group and the difference was statistically significant (P<0.05). After 3 months of observation, of the 142 patients with acute cerebral infarction, VCI occurred in 29 patients, 113 other patients had no VCI. BDNF of the non-cognitive impairment group in the acute phase, recovery phase, and 3 months of acute cerebral infarction were higher than that in the cognitive impairment group, especially in the recovery period, and the difference was statistically significant (t=2.405, P=0.017). IL-6 and TNF-α in the non-cognitive impairment group were lower than that in the cognitive impairment group in the acute phase, recovery period, and 3 months of acute cerebral infarction, and the difference was statistically significant (P<0.05).

Conclusion

BDNF, IL-6 and TNF-α are involved in the pathological process of VCI after cerebral infarction, and BDNF has a protective effect on VCI after cerebral infarction; IL-6, TNF-α may have negative effects on VCI after cerebral infarction.

Key words: Cerebral infarction, Vascular cognitive impairment, Acute phase, Brain-derived neurotrophic factor, Interleukin-6, Tumor necrosis factor α
表1 3组一般情况的比较（Mean±SD）
组别 例数男/女 年龄（岁） 收缩压（mmHg） 舒张压（mmHg） 空腹血糖（mmol/L）
非认证障碍组 113 59/54 63.98±9.74 134.88±12.72 80.76±6.66 6.04±0.91
认知障碍组 29 17/12 64.99±9.29 136.24±12.03 82.17±7.74 6.09±1.14
对照组 40 22/18 59.92±8.65 131.9±9.63 78.50±6.94 6.05±0.74
χ2/F值 ? 0.172 3.305 1.522 2.254 0.146
P值 ? 0.678 0.039 0.221 0.082 0.864
表2 研究组各时间段与对照组BDNF、IL-6、TNF-α比较（Mean±SD）
组别 例数 BDNF（ng/mL） IL-6（pg/mL） TNF-α（pg/mL）
对照组 40 3.62±1.15 4.39±0.59 1.33±0.30
急性脑梗死急性期 142 5.63±2.52 10.94±3.02 1.84±0.61
急性脑梗死恢复期 142 6.09±2.41 6.53±1.88 1.52±0.43
急性脑梗死3个月 142 4.03±1.79 4.86±0.81 1.40±0.37
表3 不同预后急性脑梗死患者各时间段BDNF、IL-6、TNF-α的比较（Mean±SD）
组别 例数 急性期 恢复期 脑梗死后3个月
BDNF（ng/mL） IL-6（pg/mL） TNF-α（pg/mL） BDNF（ng/mL） IL-6（pg/mL） TNF-α（pg/mL） BDNF（ng/mL） IL-6（pg/mL） TNF-α（pg/mL）
非认知障碍组 29 5.78±2.59 10.06±2.42 1.77±0.60 6.32±2.43 6.21±1.73 1.48±0.42 4.07±1.77 4.79±0.77 1.38±0.36
认知障碍组 113 5.04±2.18 14.39±2.65 2.08±0.59 5.14±2.14 7.77±1.92 1.69±0.45 3.86±1.87 5.15±0.90 1.46±0.39
t值 ? 1.409 -8.416 -2.514 2.405 -4.244 -2.350 0.565 -2.190 -1.000
P值 ? 0.161 0.000 0.013 0.017 0.000 0.020 0.573 0.030 0.319
[1]
陈雪梅，方丽，顾明霞.血管性认知障碍患者血清BACE1、sRAGE水平变化[J].中国临床研究, 2014, 27(3): 274-276.
[2]
Teng Z, Dong Y, Zhang D, et al. Cerebral small vessel disease and post-stroke cognitive impairment[J]. Int J Neurosci, 2017, 127(9): 824-830
[3]
欧春影，李传玲.血管性痴呆相关危险因素及其机制的研究新进展[J].中华临床医师杂志(电子版), 2016, 10(2): 248-251.
[4]
Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis[J]. Lancet Neurol, 2009, 8(11): 1006-1018.
[5]
Zuliani G, Ranzini M, Guerra G, et al. Plasma cytokines profile in older subjects with late onset alzheimer’s disease or vascular dementia[J]. J Psychiatr Res, 2007, 41(8): 686-693.
[6]
Hotter B, Hoffmann S, Ulm L, et al. IL-6 plasma levels correlate with cerebral perfusion deficits and infarct sizes in stroke patients without associated infections[J]. Front Neurol, 2019, 10: 83.
[7]
Lu WJ, Zeng LL, Wang Y, et al. Blood microRNA-15a correlates with IL-6, IGF-1 and acute cerebral ischemia[J]. Curr Neurovasc Res, 2018, 15(1): 63-71.
[8]
Chen L, Yang Q, Ding R, et al. Carotid thickness and atherosclerotic plaque stability, serum inflammation, serum MMP-2 and MMP-9 were associated with acute cerebral infarction[J]. Exp Ther Med, 2018, 16(6): 5253-5257.
[9]
中国痴呆与认知障碍指南写作组，中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(一):痴呆及其分类诊断标准[J].中华医学杂志, 2018, 98(13): 965-970.
[10]
张雪红，徐小红，王晟东,等.血管性痴呆与外周血脑源性神经营养因子水平关联性的Meta分析[J].中华全科医学, 2014, 12(6): 922-924.
[11]
袁彬，张黎军，李青,等.动脉粥样硬化血栓形成性脑梗死患者血清淀粉样蛋白A1基因多态性与颈动脉粥样硬化的相关性[J].中华脑科疾病与康复杂志(电子版), 2016, 6(2): 65-68.
[12]
Uslu S, Akarkarasu ZE, Ozbabalik D, et al. Levels of amyloid beta-42, interleukin-6 and tumor necrosis factor-alpha in Alzheimer's disease and vascular dementia[J]. Neurochem Res, 2012, 37(7): 1554-1559.
[13]
Magalhães CA, Ferreira C, Loures CMG, et al. Leptin, hsCRP, TNF-α and IL-6 levels from normal aging to dementia: relationship with cognitive and functional status[J]. J Clin Neurosci, 2018, 56: 150-155.
[14]
Utkan T, Yazir Y, Karson A, et al. Etanercept improves cognitive performance and increases eNOS and BDNF expression during experimental vascular dementia in streptozotocin-induced diabetes[J]. Curr Neurovasc Res, 2015, 12(2): 135-146.
[15]
Baydyuk M, Xu B. BDNF signaling and survival of striatal neurons[J]. Front Cell Neurosci, 2014, 8: 254.
[16]
Rothman SM, Griffioen KJ, Wan R, et al. Brain-derived neurotrophic factor as a regulator of systemic and brain energy metabolism and cardiovascular health[J]. Ann N Y Acad Sci, 2012, 1264: 49-63.
[17]
Rezaei M, Cavaco ACM, Seebach J, et al. Signals of the neuropilin-1-MET axis and cues of mechanical force exertion converge to elicit inflammatory activation in coherent endothelial cells[J]. J Immunol, 2019, 202(5): 1559-1572.
[18]
柴伟，周丽，刘春辉,等.脑脊液IL-6和TNF-α表达水平在血管性认知功能障碍诊断中的临床价值[J].中国医学前沿杂志(电子版), 2018, 10(11): 57-60.
[19]
Kamnaksh A, Kovesdi E, Kwon SK, et al. Factors affecting blast traumatic brain injury[J]. J Neurotrauma, 2011, 28(10): 2145-2153.
[20]
Duan W, Gui L, Zhou Z, et al. Adenosine A2A receptor deficiency exacerbates white matter lesions and cognitive deficits induced by chronic cerebral hypoperfusion in mice[J]. J Neurol Sci, 2009, 285(1-2): 39-45.
[1] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[2] 刘宏达, 邵祥忠, 李林, 许小伟. 海安地区动脉粥样硬化性脑梗死患者CYP2C19基因多态性及与氯吡格雷抵抗的关系[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 234-240.
[3] 王静, 何彬. 经颅彩色多普勒超声联合血sCD40L、Fib、PAF对短暂性脑缺血发作后脑梗死的预测效果[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 222-227.
[4] 王景景, 符锋, 李建伟, 任党利, 陈翀, 刘慧, 孙洪涛, 涂悦. 针刺对中型创伤性颅脑损伤后BDNF/TrkB信号通路的影响[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 199-205.
[5] 马丽. CT灌注联合血管成像预测急性脑梗死患者近期神经功能预后的价值分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(04): 229-234.
[6] 许秀兰, 朱建建. 血压变异性与伴H型高血压的急性脑梗死患者预后不良的临床关系分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(04): 199-204.
[7] 王姗姗, 徐小汝, 史振仙, 张德杰. 丹参多酚酸联合尤瑞克林治疗急性分水岭脑梗死的疗效及对认知功能、脑血流动力学和血清LPA、ox-LDL、MMP-9水平的影响[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(03): 142-149.
[8] 宁丽娜, 熊杰. 醒脑开窍针刺法结合舌部针刺治疗脑梗死后构音障碍的疗效观察[J]. 中华针灸电子杂志, 2023, 12(04): 146-150.
[9] 丁晶, 李培雯, 许迎春. 醒脑开窍针刺法在神经急重症中的应用[J]. 中华针灸电子杂志, 2023, 12(04): 161-164.
[10] 朱敏, 李法强. 血清GFAP、UCH-L1联合VILIP-1水平对急性脑梗死神经功能预后不良的预测研究[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 452-457.
[11] 王俊杰, 尹晓亮, 刘二腾, 陆军, 祁鹏, 胡深, 杨希孟, 陈鲲鹏, 张东, 王大明. 机器学习对预测颈内动脉非急性闭塞患者血管内再通术成功的潜在价值[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 464-470.
[12] 李秦鹏, 王其涛, 朱媛媛, 周琦, 刘笑言, 许勇. 颈动脉彩色多普勒超声、颈部CT血管成像及脑部CT灌注成像在脑梗死并发颈动脉狭窄患者中的应用研究[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 482-488.
[13] 邱甜, 杨苗娟, 胡波, 郭毅, 何奕涛. 亚低温治疗脑梗死机制的研究进展[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 518-521.
[14] 李安, 张秀萍, 白波, 赵阳, 薛国芳, 李东芳. 主动脉夹层术后并发神经系统并发症二例及文献复习[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 373-378.
[15] 许志威, 刘辉华, 覃伟钊, 封桂宇, 李贤, 覃翠, 林洁洁, 梁国辉. 芪蛭丹通络胶囊治疗非急性期缺血性中风气虚血瘀证的临床疗效[J]. 中华脑血管病杂志(电子版), 2023, 17(03): 232-236.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号