缺血性脑卒中后认知障碍患者血清肺腺癌转移相关转录因子-1及硫氧还蛋白互作蛋白水平的变化及意义

Changes and significance of serum malat and TXNIP levels in patients with cognitive impairment after cerebral ischemia and stroke

摘要:

目的 分析缺血性脑卒中后认知障碍患者血清肺腺癌转移相关转录因子1（MALAT1）及硫氧还蛋白互作蛋白（TXNIP）水平变化及意义。方法 本研究为前瞻性研究。选取2019年2月—2021年4月就诊于唐山市工人医院的150例缺血性脑卒中患者，根据蒙特利尔认知评估量表（MoCA）评分将患者分为研究组（缺血性脑卒中后认知障碍）和对照组（缺血性脑卒中未伴有认知障碍）。对比两组血清MALAT1水平、TXNIP水平、MoCA评分、磁共振波谱水平；采用Pearson法分析血清MALAT1、TXNIP水平与MoCA评分、磁共振波谱水平的相关性；绘制ROC曲线分析血清MALAT1、TXNIP单独及联合预测认知障碍发生的价值。结果 150例缺血性脑卒中患者中，有58例为缺血性脑卒中认知障碍，占比38.67%；研究组血清MALAT1、TXNIP水平高于对照组，MoCA量表各维度及总评分低于对照组（P <0.05）；研究组NAA1/NAA2低于对照组，Cho1/Cho2、Lac1/Cr2高于对照组（P <0.05）；缺血性脑卒中后患者血清MALAT1、TXNIP水平与MoCA总分（r =-0.623和-0.512，均P =0.000）、NAA1/NAA2（r =-0.459和-0.413，均P =0.000）呈负相关，与Cho1/Cho2（r =0.569和0.496，均P =0.000）、Lac1/Cr2（r =0.523和0.475，均P =0.000）呈正相关；ROC曲线结果显示，血清MALAT1、TXNIP及两者联合预测缺血性脑卒中后认知障碍发生的AUC为0.860（95% CI：0.796，0.924）、0.780（95% CI：0.703，0.856）、0.890（95% CI：0.834，0.945），敏感性分别为86.7%（95% CI：0.776，0.933）、78.3%（95% CI：0.711，0.863）、90.2%（95% CI：0.839，0.951），特异性分别为79.7%（95% CI：0.702，0.869）、71.2%（95% CI：0.612，0.798）、85.1%（95% CI：0.736，0.915）。结论 缺血性脑卒中后认知障碍患者血清MALAT1、TXNIP水平呈高表达，两者水平与患者认知功能、磁共振波谱水平密切相关，且两者联合可有效预测认知障碍的发生。

Abstract:

Objective To analyze the changes and significance of serum lung adenocarcinoma metastasis related transcription factor-1 (malat1) and thioredoxin interacting protein (TXNIP) in patients with cognitive impairment (CI) after cerebral ischemia and stroke.Methods This study was a prospective study. 150 patients with cerebral ischemic stroke presenting to Tangshan Workers' Hospital from February 2019 to April 2021 were divided into study group (CI after cerebral ischemic stroke) and control group (CI without cerebral ischemic stroke) according to the Montreal Cognitive Assessment (MoCA) score. The levels of serum MALAT1, TXNIP, MoCA and magnetic resonance spectroscopy were compared between the two groups, Pearson was used to analyze the correlation of serum MALAT1 and TXNIP with MOCA score and magnetic resonance spectroscopy. ROC curve was used to analyze the value of serum MALAT1 and TXNIP in predicting CI.Results Of the 150 patients with cerebral ischemic stroke, 58 patients were diagnosed with cerebral ischemic stroke CI, accounting for 38.67%;Serum MALAT1 and TXNIP levels were higher in the study group than in the control group, The dimensions and total score of the MoCA scale were lower than the control group, The difference was significant (P < 0.05); NAA1/NAA2 was lower than the control group, Cho1/Cho2, LAC1/Cr2 were higher than the control group, The difference was significant (P < 0.05); Serum MALAT1, TXNIP levels and total MoCA scores in patients after cerebral ischemic stroke (r = -0.623 and -0.512, all P = 0.000), NAA1/NAA2 (r = -0.459 and -0.413, all P = 0.000) showed a negative correlation (P < 0.05), With Cho1/Cho2 (r = 0.569 and 0.496, all P = 0.000), LAC1/Cr2 (r = 0.523 and 0.475, all P = 0.000) showed a positive correlation (P < 0.05); Mapping the ROC results shows that, Serum MALAT1, TXNIP and the combined AUC for predicting CI after cerebral ischemic stroke were 0.860 (95% CI: 0.796, 0.924), 0.780 (95% CI: 0.703, 0.856), 0.890 (95% CI: 0.834, 0.945), Sensitivity was 0.867 (95% CI: 0.776, 0.933), 0.783 (95% CI: 0.711, 0.863), 0.902 (95% CI: 0.839, 0.951), Speciality is 0.797 (95% CI: 0.702, 0.869), 0.712 (95% CI: 0.612, 0.798), 0.851 (95% CI: 0.736, 0.915) .Conclusion The levels of serum MALAT1 and TXNIP are highly expressed in CI patients after cerebral ischemic stroke. The level of MALAT1 and TXNIP are closely related to the cognitive function and the level of magnetic resonance spectroscopy.