血Kir4.1蛋白浓度与脑白质病变程度的相关性研究
发布时间：2018-07-17 19:56
【摘要】：目的：近年来随着神经影像的进步，尤其是磁共振成像的普及，脑白质病变（White matter lesion, WML）已成为中老年人群中头核磁诊断报告中频繁出现的一个诊断。其在影像学上主要表现为：脑室周围或皮层下T2W（IT2-weighted imaging）高信号。脑白质病最显著的临床表现是精神状态和认知功能的改变，即在没有失语的情况下出现注意力、记忆力、视觉空间技能、执行功能和情感状态等其中一项或几项缺陷。严重病例还可出现痴呆、瘫痪、视力丧失、昏迷甚至死亡。脑白质病（Leukoencephalopathy）最主要的特征为中枢神经细胞的髓鞘损害，多发性硬化属于脑白质病的一个特殊类型。内向整流性钾离子通道蛋白-4.1（Inwardlyrectifying potassium channel4.1, Kir4.1），最近分别被确定为多发性硬化和视神经脊髓炎自身抗体应答的靶分子。为了探讨临床常见的脑白质病变与Kir4.1蛋白是否也存在相关性，我们进一步分析了血中Kir4.1蛋白浓度与临床常见的脑白质病变的关系，此也为探索血Kir4.1蛋白作为脑白质病变临床诊断和治疗的神经生物标志物提供了理论基础。 方法：2013年3月~8月期间，通过对因头晕、认知或情感功能障碍就诊于大连医科大学附属第一、第二医院神经内科并使用1.5-T MR进行头颅扫描的核磁扫描结果进行图像判别，，选择性收集脑白质病变按照“the Rotterdam Study”的图像判读协议评级提示为重度损害的患者的作为病例组，共14例，其中脑室周围白质病变为8例，皮层下白质病变6例；选择性收集脑白质病变按上述评级标准提示为无或轻微损害的患者作为对照组，共10例。整理所有患者的详细临床资料，并留取血液标本，通过酶联免疫吸附测定法（Enzyme-linked immunosorbent assay,ELISA）测定标本中Kir4.1蛋白的浓度。通过软件分析血中Kir4.1浓度与脑白质病变的相关性。 结果：1、对病例特点进行分析，病例组和对照组的年龄、人数、体重指数对比无显著性差异，病例组和对照组的中高血压患病率、血脂异常、糖尿病患病率对比均无显著性差异。 2、对相关危险因素的分析，病例组和对照组的收缩压、舒张压、空腹血糖、心率、收缩压、高密度脂蛋白（HDL-c）、胆固醇、低密度脂蛋白（LDL-c）、同型半胱氨酸（HCY）无显著性差异；病例组和对照组的血甘油三酯水平存在显著性差异（P0.05），在单变量的Logistic回归分析中，甘油三酯（OR,1.05;95%CI,0.958-1.151; P=0.297），说明甘油三酯是脑白质病变的危险因素。 3、对血K4.1蛋白的分析，病例组与对照组进行血Kir4.1蛋白浓度对比存在显著性差异（P0.05），说明脑白质病变和血Kir4.1蛋白浓度存在一定的相关性；病例组被分为脑室周围白质病变组和皮层下白质病变组，两两对比，皮层下脑白质病变组与对照组进行血Kir4.1蛋白浓度对比存在显著性差异（P0.05），说明血Kir4.1蛋白浓度和皮层下脑白质病变存在一定的相关性；其余两组对比无显著性差异。 结论：1、血甘油三酯水平升高可能是脑白质病变的一个危险因素。 2、脑白质病变患者的血Kir4.1蛋白浓度升高，尤以皮层下脑白质病变患者明显。
[Abstract]:Objective : In recent years , with the progress of neuroimaging , especially the popularization of magnetic resonance imaging , white matter lesion ( WML ) has become a frequently occurring diagnosis in the middle - aged and elderly population . The most significant clinical manifestation of leukoencephalopathy is the change of mental state and cognitive function .
Methods : From March to August 2013 , 14 cases of patients with severe impairment were classified according to the image interpretation protocol of " the brain study " by using 1.5 - T MR imaging in the first and second hospitals of Dalian Medical University .
Selective collection of leukoencephalopathy was presented as a control group for patients with no or mild impairment according to the above - mentioned rating criteria . Detailed clinical data were collected from all patients and blood samples were collected . The concentration of Kir4.1 protein in the specimen was determined by enzyme - linked immunosorbent assay ( ELISA ) . The correlation between Kir4.1 concentration in blood and leukoencephalopathy was analyzed by software .
Results : 1 . There was no significant difference in the age , number and body mass index between the case group and the control group . There was no significant difference in the prevalence of hypertension , blood lipid and diabetes in the case group and the control group .
2 . Analysis of relevant risk factors , systolic blood pressure , diastolic pressure , fasting blood glucose , heart rate , systolic blood pressure , high density lipoprotein ( HDL - c ) , cholesterol , low density lipoprotein ( LDL - c ) and homocysteine ( HCY ) were not significantly different between the case group and the control group .
There was a significant difference in serum triglyceride levels between the case group and the control group ( P0.05 ) . In the logistic regression analysis of the single variable , the triglycerides ( OR , 1.05 ; 95 % CI , 0.958 - 1.151 ; P = 0.297 ) were found to be a risk factor for the brain white matter lesions .
3 . There was a significant difference in the concentration of Kir4.1 protein in the case group and the control group ( P0.05 ) , which showed that there was a certain correlation between the brain white matter and the blood Kir4.1 protein concentration .
Compared with the control group , there was a significant difference between the concentration of Kir4.1 protein and the plasma Kir4.1 protein concentration ( P0.05 ) .
There was no significant difference between the two groups .
Conclusion : 1 . The elevated level of triglyceride may be a risk factor for leukoencephalopathy .
2 . The plasma Kir4.1 protein concentration in the patients with leukoencephalopathy increased , especially in the patients with cerebral white matter lesions .
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742
本文编号：2130770
[Abstract]:Objective : In recent years , with the progress of neuroimaging , especially the popularization of magnetic resonance imaging , white matter lesion ( WML ) has become a frequently occurring diagnosis in the middle - aged and elderly population . The most significant clinical manifestation of leukoencephalopathy is the change of mental state and cognitive function .
Methods : From March to August 2013 , 14 cases of patients with severe impairment were classified according to the image interpretation protocol of " the brain study " by using 1.5 - T MR imaging in the first and second hospitals of Dalian Medical University .
Selective collection of leukoencephalopathy was presented as a control group for patients with no or mild impairment according to the above - mentioned rating criteria . Detailed clinical data were collected from all patients and blood samples were collected . The concentration of Kir4.1 protein in the specimen was determined by enzyme - linked immunosorbent assay ( ELISA ) . The correlation between Kir4.1 concentration in blood and leukoencephalopathy was analyzed by software .
Results : 1 . There was no significant difference in the age , number and body mass index between the case group and the control group . There was no significant difference in the prevalence of hypertension , blood lipid and diabetes in the case group and the control group .
2 . Analysis of relevant risk factors , systolic blood pressure , diastolic pressure , fasting blood glucose , heart rate , systolic blood pressure , high density lipoprotein ( HDL - c ) , cholesterol , low density lipoprotein ( LDL - c ) and homocysteine ( HCY ) were not significantly different between the case group and the control group .
There was a significant difference in serum triglyceride levels between the case group and the control group ( P0.05 ) . In the logistic regression analysis of the single variable , the triglycerides ( OR , 1.05 ; 95 % CI , 0.958 - 1.151 ; P = 0.297 ) were found to be a risk factor for the brain white matter lesions .
3 . There was a significant difference in the concentration of Kir4.1 protein in the case group and the control group ( P0.05 ) , which showed that there was a certain correlation between the brain white matter and the blood Kir4.1 protein concentration .
Compared with the control group , there was a significant difference between the concentration of Kir4.1 protein and the plasma Kir4.1 protein concentration ( P0.05 ) .
There was no significant difference between the two groups .
Conclusion : 1 . The elevated level of triglyceride may be a risk factor for leukoencephalopathy .
2 . The plasma Kir4.1 protein concentration in the patients with leukoencephalopathy increased , especially in the patients with cerebral white matter lesions .
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742
【参考文献】
相关期刊论文 前1条
1 陆彤;蒋彬;;内向整流性钾离子通道家族[J];中国心脏起搏与心电生理杂志;2009年03期
本文编号：2130770
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