血清可溶性CD40配体、β淀粉样蛋白1-42水平对卒中后认知功能障碍的诊断效能

发布时间：2018-02-01 03:06

  本文关键词： 可溶性CD配体 β淀粉样蛋白- 卒中后认知障碍 脑卒中　出处：《山东医药》2017年43期 　论文类型：期刊论文

【摘要】：目的探讨血清可溶性CD40配体(s CD40L)、β淀粉样蛋白1-42(Aβ1-42)水平对卒中后认知障碍(PSCI)的诊断效能。方法急性脑梗死患者118例(脑梗死组),发病后3个月时进行蒙特利尔量表(Mo CA)评分并据此将其分为脑梗死认知障碍组64例、脑梗死认知正常组54例,同期将51例身体健康者纳入对照组。酶联免疫吸附法检测各组血清s CD40L、Aβ1-42,并进行比较,分析血清s CD40L、Aβ1-42水平与脑梗死认知障碍的关系,通过绘制受试者工作特征曲线(ROC)分析s CD40L、Aβ1-42水平对脑梗死认知障碍的诊断效能。结果 (1)脑梗死认知障碍组、脑梗死认知正常组、对照组血清s CD40L水平分别为(3.820±1.236)、(3.261±1.131)、(2.663±1.303)ng/m L,三组间任意两组相比,P均0.01;脑梗死认知障碍组、脑梗死认知正常组、对照组血清Aβ1-42水平分别为(94.404±37.332)、(127.936±34.877)、(158.023±35.994)pg/m L,三组间任意两组相比,P均0.01。(2)脑梗死组血清s CD40L水平与Mo CA评分呈负相关(r=-0.640,P0.01),血清Aβ1-42水平与Mo CA评分呈正相关(r=0.758,P0.01),血清s CD40L水平与血清Aβ1-42水平呈负相关(r=-0.960,P0.01)。(3)脑梗死组血清s CD40L水平ROC的曲线下面积为0.644,血清Aβ1-42水平ROC的曲线下面积为0.740,血清s CD40L联合Aβ1-42水平ROC的曲线下面积为0.918;根据约登指数,入组时s CD40L值为3.60 ng/m L,其诊断脑梗死认知障碍的阳性预测值为71.154%、阴性预测值为59.091%、正确诊断率为57.812%;入组时Aβ1-42值为114.34 pg/m L,其诊断脑梗死认知障碍的阳性预测值为77.966%、阴性预测值为69.491%、正确诊断率为71.875%;s CD40L、Aβ1-42联合应用诊断脑梗死认知障碍的阳性预测值为89.855%、阴性预测值为95.918%、正确诊断率为96.875%。结论脑梗死认知障碍患者血清s CD40L水平升高、Aβ1-42水平降低,两者与Mo CA评分有关,检测血清s CD40L、Aβ1-42有助于PSCI的诊断。
[Abstract]:Objective to investigate the changes of serum soluble CD40 ligand (s CD40L), amyloid beta (A beta 1-42) 1-42 levels of cognitive disorder after stroke (PSCI) and the diagnostic efficacy. Methods 118 patients with acute cerebral infarction (ACI), 3 months after the onset of the Montreal scale (Mo CA) score and then it is divided into cerebral infarction group and 64 cases of cerebral infarction cognitive impairment, cognitive normal group of 54 cases, the same period 51 cases of healthy persons in the control group. Enzyme linked immunosorbent assay to detect the serum s CD40L, A beta 1-42, and carry on the comparison, analysis of serum s CD40L, A beta 1-42 level and cerebral infarction cognitive impairment. Through the receiver operating characteristic curve (ROC) analysis of s CD40L. The diagnostic efficacy of A beta 1-42 level on cerebral infarction cognitive impairment. The cognitive impairment (1) cerebral infarction group, cerebral infarction cognitive normal group, control group of serum s CD40L levels were (3.820 + 1.236), (3.261 + 1.131), (2.663. 1.303) ng/m L,涓夌粍闂翠换鎰忎袱缁勭浉姣，

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