摘要
目的探讨血小板反应蛋白1(TSP-1)对老年病人脑卒中后癫痫(PSE)、炎症反应及认知功能的影响。方法选取2018年1月至2019年6月在我院急诊就诊的204例老年缺血性脑卒中病人,根据脑卒中7 d后有无发生PSE分为PSE组(n=23)及非PSE组(n=181)。比较2组病人血清外泌体蛋白TSP-1表达的差异,采用单因素和多因素Logistic回归分析老年脑卒中病人发生PSE的影响因素,采用ROC曲线分析TSP-1对老年脑卒中病人发生PSE的预测价值,采用Pearson相关及Spearman相关分析TSP-1表达与炎症因子和认知损害的相关性。结果PSE组病人TSP-1表达显著高于非PSE组病人(P<0.01)。多因素Logistic回归分析显示,发热、低钙血症、美国国立卫生研究院卒中量表评分、TSP-1均是老年脑卒中病人发生PSE的独立影响因素。ROC曲线分析显示,TSP-1表达预测老年脑卒中病人发生PSE的AUC为0.886(95%CI0.829~0.943),特异度和灵敏度分别为81.8%和87.0%。Pearson相关性分析显示,PSE病人TSP-1表达与IL-6、转化生长因子β1(TGF-β1)、TNF-α水平呈显著正相关(r=0.699、0.919、0.680,P<0.001)。Spearman相关性分析显示,PSE病人TSP-1表达与MMSE量表得分差值呈负相关(r=-0.768,P<0.001)。结论对于老年缺血性脑卒中病人,血清外泌体蛋白TSP-1高表达者更易发生PSE,且TSP-1高表达与炎症反应及认知损害相关。
Objective To investigate the effects of serum exosomal protein thrombospondin-1(TSP-1)on inflammatory reaction and cognitive function in the elderly patients with post-stroke epilepsy(PSE).Methods A total of 204 elderly patients with ischemic stroke admitted to the emergency department of our hospital from January 2018 to June 2019 were selected and divided into PSE group(n=23)and non-PSE group(n=181)according to whether PSE occurred 7 days after stroke.The expression of TSP-1 was compared between the two groups.Univariate and multivariate Logistic regression was used to analyze the influencing factors of PSE in the elderly.The predictive value of TSP-1 was analyzed by receiver operating characteristic(ROC)curve.Pearson and Spearman correlation analysis was used to analyze the correlation of TSP-1 expression with inflammatory factors and cognitive impairment in PSE patients.Results The expression of TSP-1 in PSE group was significantly higher than that in non-PSE group(P<0.01).Multivariate Logistic regression analysis showed that fever,hypocalcemia,the National Institutes of Health Stroke Scale(NIHSS)score and TSP-1 were independent influencing factors of PSE in the elderly stroke patients.ROC curve analysis showed that the predictive efficacy of TSP-1 was 0.886(95%CI 0.829-0.943),the specificity and sensitivity were 81.8%and 87.0%,respectively.According to Pearson correlation analysis,the expression of TSP-1 in PSE patients was positively correlated with the levels of interleukin-6(IL-6),transforming growth factor beta 1(TGF-β1)and tumor necrosis alpha(TNF-α)(r=0.699,0.919,0.680,respectively,P<0.001).Spearman correlation analysis showed that TSP-1 was negatively correlated with the difference of Mini-mental State Examination(MMSE)(r=-0.768,P<0.001).Conclusion In the elderly patients with ischemic stroke,PSE is more prone to occur in those with high expression of TSP-1,and the high expression of TSP-1 is associated with the inflammation and cognitive impairment of PSE patients.
作者
王为
赵蒙
李昀
殷宏宇
WANG Wei;ZHAO Meng;LI Yun;YIN Hong-yu(Departments of Neurology,Xinhua Hospital Affiliated to Dalian University,Dalian 116000,China;Department of Neurolgy,Weifang People′s Hospital,Weifang 261000,China;Department of Neuroelectrophysiology,Dalian Central Hospital,Dalian 116000,China)
出处
《实用老年医学》
CAS
2022年第5期453-458,共6页
Practical Geriatrics
基金
大连市科技计划项目(2017E15SF146)。
