| 吴红稳,李苏苏.多模态 MRI参数联合血清 LCN2、GSK-3β水平评估脑小血管病认知障碍的价值[J].安徽医药,2025,29(12):2438-2442. |
| 多模态 MRI参数联合血清 LCN2、GSK-3β水平评估脑小血管病认知障碍的价值 |
| Value of multimodal MRI parameters combined with serum LCN2 and GSK-3β levels in evaluating cognitive impairment in cerebrovascular disease |
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| DOI：10.3969/j.issn.1009-6469.2025.12.022 |
| 中文关键词: 大脑小血管疾病 认知障碍 脂质运载蛋白 2 糖原合酶激酶 -3β 多模态磁共振成像 |
| 英文关键词: Cerebral small vessel disease Cognitive impairment Lipocalin-2 Glycogen synthase kinase-3β Multimodal mag-netic resonance imaging |
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| 中文摘要: |
| 目的探究多模态磁共振成像( MRI)参数联合血清脂质运载蛋白 2(LCN2)、糖原合酶激酶 -3β(GSK-3β)水平评估脑小血管病( CSVD)认知障碍的价值。方法前瞻性选取中国人民解放军总医院第二医学中心 2021年 3月至 2023年 3月收治的 106例 CSVD病人，根据认知功能分为认知功能障碍 50例即为研究组，认知功能正常 56例即为健康组。采用酶联免疫吸附分析(ELISA)检测血清中 LCN2、GSK-3β水平；多模态 MRI检测脑白质病变( WMLs)体积、 WMLs评分、脑微出血( CMBs)。多因素 logistic回归分析 CSVD病人认知功能障碍发生的影响因素。受试者操作特征曲线( ROC曲线)分析多模态 MRI参数联合血清 LCN2、GSK-3β水平对 CSVD病人认知功能障碍发生的评估价值。结果与健康组［(4.65±0.51)μg/L、(27.45±3.10)IU/L］相比，研究组血清中 LCN2(5.63±0.58)μg/L、GSK-3β(32.51±3.45)IU/L水平显著升高( P<0.05)。 Pearson相关性分析显示，血清中 LCN2、GSK-3β水平与简易精神状态检查( MMSE)评分呈正相关关系( r=0.63、0.72，均 P<0.001)。与健康组相比，研究组 WMLs评分、 WMLs体积、 CMBs数量显著升高( P<0.05)。多因素 logistic回归分析结果显示，超敏 C反应蛋白( hs-CRP)、 MMSE评分、 LCN2、GSK-3β水平是影响 CSVD病人认知功能障碍发生的因素( P<0.05)。多模态 MRI参数联合血清 LCN2、GSK-3β水平诊断 CSVD病人认知功能障碍发生的 AUC与单独诊断相比显著升高( Z=5.24、4.58、4.10、5.81、5.78，均 P<0.001)。结论 CSVD合并认知功能障碍病人血清中 LCN2、GSK-3β水平显著升高，多模态 MRI参数联合血清 LCN2、GSK-3β水平能够提高诊断 CSVD病人认知功能障碍发生的价值。 |
| 英文摘要: |
| Objective To explore the value of multimodal magnetic resonance imaging (MRI) parameters combined with serum levelsof lipocalin 2 (LCN2) and glycogen synthase kinase-3β (GSK-3β) in evaluating cognitive impairment in cerebral small vessel disease (CSVD).Methods A total of 106 patients with CSVD admitted to The Second Medical Center of the Chinese People's Liberation ArmyGeneral Hospital from March 2021 to March 2023 were prospectively selected. According to cognitive function, they were divided into50 cases with cognitive dysfunction as the study group and 56 cases with normal cognitive function as the healthy group. The levels ofLCN2 and GSK-3β in serum were detected by enzyme-linked immunosorbent assay (ELISA). Multimodal MRI was applied to detect thewhite matter lesions (WMLs) volume, WMLs scores, and cerebral microbleeds (CMBs). Multivariate Logistic regression was applied toanalyze the influencing factors of cognitive impairment in CSVD patients. ROC curve was applied to analyze the evaluation value ofmultimodal MRI parameters combined with serum LCN2 and GSK-3β levels in the occurrence of cognitive impairment in CSVD pa-tients. Results Compared with the healthy group [(4.65±0.51) μg/L, (27.45±3.10) IU/L], the levels of LCN2 (5.63±0.58) μg/L and GSK-3β (32.51±3.45) IU/L in the serum of the study group were significantly increased (P < 0.05). Pearson correlation analysis showed that the levels of LCN2 and GSK-3β in the serum were positively correlated with the MMSE score (r = 0.63, 0.72, all P < 0.001). Com-pared with the healthy group, the WMLs score, WMLs volume, and the number of CMBs in the study group were significantly increased(P < 0.05). The results of multivariate Logistic regression analysis showed that hs-CRP, MMSE score, LCN 2, and GSK-3β levels were factors affecting the occurrence of cognitive dysfunction in CSVD (P < 0.05). The combination of multimodal MRI parameters and se-rum LCN2 and GSK-3β levels had an obviously higher AUC in diagnosis of cognitive impairment in CSVD patients than the individual diagnosis (Z = 5.24, 4.58, 4.10, 5.81, 5.78, all P < 0.001).Conclusions The serum levels of LCN2 and GSK-3β are obviously elevat-ed in patients with CSVD combined with cognitive impairment. The combination of multimodal MRI parameters and serum LCN2 andGSK-3β levels can improve the diagnostic value of cognitive impairment in CSVD patients. |
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