白细胞介素-18、趋化因子配体2在血管性认知损害患者中的表达意义及诊断效能分析

Analysis of significance and diagnostic efficacy of IL-18 and C-C motif ligand 2 expressions in patients with vascular cognitive impairment

摘要:

目的 探讨白细胞介素-18（IL-18）、趋化因子配体2（CCL2）在血管性认知损害（VCI）患者中的表达意义及对VCI的诊断效能。方法 选取粤北人民医院和韶关学院医学院附属医院2019年1月—2020年4月收治的脑小血管病患者140例，根据其是否发生VCI分成VCI组（n =76）和非VCI组（n =64）。采用蒙特利尔认知评价量表（MoCA）评价两组患者的认知功能。采用酶联免疫吸附试验（ELISA）检测患者血清IL-18、CCL2水平。Pearson法分析MoCA总分与血清IL-18、CCL2的相关性。绘制受试者工作特征（ROC）曲线分析血清IL-18、CCL2对VCI的诊断效能。结果 VCI组视空间与执行能力、命名、记忆、注意、语言、抽象、延迟回忆及总分低于非VCI组（P <0.05）。VCI组血清IL-18、CCL2水平高于非VCI组（P <0.05）。MoCA总分与血清IL-18水平（r =-0.828，P =0.000）、CCL2水平（r =-0.738，P =0.000）均呈负相关。血清IL-18水平诊断VCI的曲线下面积（AUC）为0.772（95%CI：0.692，0.852），敏感性为72.40%（95% CI：0.715，0.858），特异性为73.40%（95% CI：0.698，0.897）；血清CCL2水平诊断VCI的AUC为0.722（95% CI：0.636，0.808），敏感性为70.30%（95% CI：0.619，0.840），特异性为74.20%（95% CI：0.644，0.868）。结论 脑小血管病后VCI发生率较高，且VCI患者的血清IL-18、CCL2水平升高，两者对VCI有一定诊断价值，可作为筛查该病的重要指标。

Abstract:

Objective To investigate the expression levels of interleukin-18 (IL-18) and C-C motif ligand 2 (CCL2) in patients with vascular cognitive dysfunction (VCI), and to analyze the diagnostic efficacy of the two for this disease.Methods From January 2019 to April 2020, 140 patients with cerebral small vessel disease admitted to our hospital were divided into VCI group (n = 76) and non-VCI group (n = 64) according to whether VCI occurred. After admission, the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of the two groups of patients. In the fasting state, 4ml of fasting cubital venous blood was collected, centrifuged, and serum was taken to measure serum IL-18 and CCL2 levels by enzyme-linked immunosorbent assay. Pearson linear correlation was used to analyze the correlation between MoCA total score and serum IL-18 and CCL2. The receiver operating characteristic curve (ROC) was drawn to clarify the diagnostic efficacy of serum IL-18 and CCL2 for VCI, and the area under the curve (AUC) and the optimal limit value were determined.Results The visual space function, memory function, attention, executive function, language function, calculation score, and total score of the VCI group were lower than those of the non-VCI group (P < 0.05). Correlation analysis showed that the total score of MoCA was negatively correlated with serum IL-18 level (r = -0.828, P = 0.000) and CCL2 level (r = -0.738, P = 0.000). The AUC of serum IL-18 and CCL2 levels in the diagnosis of VCI was 0.772 (95% CI: 0.692,0.852), sensitivity was 72.40% (95% CI: 0.715, 0.858), and specificity was 73.40% (95%CI: 0.698, 0.897); the AUC of VCI by serum CCL2 level was 0.722 (95% CI: 0.636,0.808), sensitivity was 70.30 % (95% CI: 0.619, 0.840), and specificity was 74.20% (95% CI: 0.644, 0.868).Conclusion The incidence of VCI is higher after cerebral small vessel disease, and the serum IL-18 and CCL2 of VCI patients are significantly increased. Both of them have certain value for the diagnosis of VCI and can be used as an important indicator for screening the disease.