血清HIF-1α、sFas、Livin在老年VaD中的表达及临床意义

摘要/Abstract

摘要： 目的分析血清低氧诱导因子（HIF-1α）、可溶性细胞凋亡因子（sFas）和凋亡抑制蛋白抗体（Livin）在老年血管性痴呆（VaD）患者中的表达及其意义。方法选择2019年8月~2020年10月商丘市第四人民医院收治的老年血管性痴呆患者57例作为观察组,按照临床痴呆评定量表（CDR）对57例患者进行评分,其中轻度16例,中度19例,重度22例,并选取于同期体检的20例健康人作为对照组。使用双抗体夹心酶联免疫吸附法（ELISA）监测患者血清HIF-1α、sFas和Livin的水平,并分析其与老年血管性痴呆的关系。结果观察组患者HIF-1α、sFas水平较对照组升高,Livin水平较对照组降低（P<0.01）,患者的HIF-1α水平无明显差异（P>0.05）,sFas和Livin水平在重度痴呆患者中的表达较轻中度患者降低（P<0.01）,且重度患者sFas和Livin水平较中度痴呆患者水平降低（P<0.05）。HIF-1α的水平与VaD分级无明显相关性（r=0.159,P>0.05）;sFas和Livin与VaD分级呈负相关（r= -0.482、-0.481,P值均小于0.05）。血清HIF-1α、sFas和Livin对VaD分级均有较高的诊断效能,当Livin的cut-off值为7.46 nmol/mL时的诊断效能最高,约登指数为0.821,曲线下面积（AUC）为0.821,敏感度、特异性分别为83.33%、90.91%。结论老年VaD患者血清HIF-1α水平存在一定程度的升高,但与痴呆程度无明显相关性,而sFas、Livin水平随着痴呆程度的加重而降低,与疾病严重程度呈负相关,其中Livin对于CDR的分级指导更明显。

关键词: 老年血管性痴呆, 血清低氧诱导因子, 可溶性细胞凋亡因子, Livin, 临床诊断分级

Abstract: Objective To analyze the expressions and significance of serum hypoxia-inducible factor (HIF-1α), soluble Fas (sFas) and livin in elderly patients with vascular dementia(VaD). Methods Fifty-seven elderly patients with vascular dementia admitted to the hospital from August 2019 to October 2020 were selected as observation group. The 57 patients were scored according to clinical dementia rating (CDR), including 16 mild cases, 19 moderate cases and 22 severe cases. Another 20 healthy people who underwent physical examination in the hospital during the same period were selected as control group. Double antibody sandwich enzyme-linked immunosorbent assay(ELISA) was used to monitor the levels of serum HIF-1α, sFas and Livin, and their relationships with elderly vascular dementia were analyzed. Results The levels of HIF-1α and sFas in observation group were higher than those in control group while the level of Livin was lower than that in control group (P<0.01), there was no significant difference in HIF-1α among the patients (P>0.05). The levels of sFas and Livin in patients with severe dementia were lower than those in patients with mild or moderate dementia (P<0.01), and the levels of sFas and Livin in patients with moderate dementia were lower than those in patients with mild dementia (P<0.05). HIF-1α level was not significantly correlated with VaD grading (r=0.159, P>0.05). sFas and Livin were negatively correlated with VaD grading (r=-0.482, -0.481, all P<0.05). Serum HIF-1α, sFas and Livin had high efficiency on VaD grading. When the cut-off value of Livin was 7.46 nmol/mL, the diagnostic efficiency was the highest, and its Youden index, area under the curve (AUC), sensitivity and specificity were 0.821, 0.821, 83.33% and 90.91% respectively. Conclusions erum HIF-1α level has a certain degree of increase in elderly patients with VaD, but it has no obvious correlation with the severity of dementia. sFas and Livin levels decrease with the aggravation of dementia, and are negatively correlated with the severity of disease. Livin is more obvious in grading guidance for CDR.

Key words: elderly vascular dementia, serum hypoxia-inducible factor, soluble Fas, livin, clinical diagnostic grading

中图分类号:

R749.1

戈念念, 闫向敏, 闫如冰, 刘建军. 血清HIF-1α、sFas、Livin在老年VaD中的表达及临床意义[J]. 承德医学院学报, 2022, 39(3): 200-204.

GE Nian-nian, YAN Xiang-min, YAN Ru-bing, LIU Jian-jun. Expressions and Clinical Significance of Serum HIF-1α, sFas and Livin in Elderly VaD[J]. Journal of Chengde Medical University, 2022, 39(3): 200-204.

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