血清AChE、IL-17与单纯疱疹病毒性脑炎患者认知功能障碍的相关性

doi:10.3969/j.issn.1673-8640.2023.08.003

摘要/Abstract

摘要：

目的探讨血清乙酰胆碱酯酶（AChE）和白细胞介素（IL）17水平与单纯疱疹病毒性脑炎（HSE）患者认知功能障碍的相关性。方法选取2019年3月—2021年3月邯郸市中心医院HSE患者159例（HSE组），根据是否发生认知功能障碍将所有患者分为认知障碍组（69例）和认知正常组（90例），根据简易智能精神状态检查量表（MMSE）评分将认知功能障碍患者分为轻度组（23例，MMSE评分为20~25分）、中度组（30例，MMSE评分为11~19分）和重度组（16例，MMSE评分≤10分）。以健康体检者65名作为正常对照组。检测所有研究对象血清AChE、IL-17水平。采用Pearson相关分析评估AChE和IL-17与蒙特利尔认知评估量表（MoCA）评分和MMSE评分的相关性。采用受试者工作特征（ROC）曲线分析AChE和IL-17诊断HSE患者认知功能障碍的效能。结果 HSE组血清AChE、IL-17水平均显著高于正常对照组（P<0.05）。认知障碍组血清AChE、IL-17水平均高于认知正常组（P<0.05）。重度组血清AChE、IL-17水平高于中度组和轻度组（P<0.05），中度组血清AChE、IL-17水平高于轻度组（P<0.05）。认知障碍组血清AChE、IL-17水平与MoCA评分呈负相关（r值分别为-0.311、-0.480，P<0.01），与MMSE评分亦呈负相关（r值分别为-0.349、-0.447，P<0.01）。AChE、IL-17单项检测和联合检测诊断HSE患者认知功能障碍的曲线下面积（AUC）分别为0.689、0.724、0.893。结论 HSE患者血清AChE和IL-17水平与认知功能障碍有关，且可用于评估认知功能障碍的严重程度。

关键词: 乙酰胆碱酯酶, 白细胞介素17, 单纯疱疹病毒, 病毒性脑炎, 认知功能障碍

Abstract:

Objective To investigate the correlation between serum acetylcholinesterase（AChE） and interleukin（IL）-17 levels and cognitive function impairment in patients with herpes simplex encephalitis（HSE）. Methods A total of 159 HSE patients（HSE group） in Handan Central Hospital from March 2019 to March 2021 were enrolled. The patients were classified into cognitive impairment group（69 cases） and cognitive normal group（90 cases） according to whether cognitive function impairment occurred. According to the score of the mini-mental state examination（MMSE），the patients with cognitive function impairment were classified into mild group（23 cases，MMSE score 20-25），moderate group（30 cases，MMSE score 11-19） and severe group（16 cases，MMSE score ≤10）. A total of 65 healthy subjects were enrolled as control group. Serum AChE and IL-17 levels were determined. Pearson correlation analysis was used to evaluate the correlation of AChE and IL-17 with Montreal cognitive assessment（MoCA） scores and MMSE scores. Receiver operating characteristic（ROC） curves were used to analyze the efficacy of AChE and IL-17 in diagnosing cognitive function impairment in HSE patients. Results Serum AChE and IL-17 levels in HSE group were higher than those in control group（P<0.05）. The levels of serum AChE and IL-17 in cognitive impairment group were higher than those in cognitive normal group（P<0.05）. The levels of serum AChE and IL-17 in severe group were higher than those in moderate group and mild group（P<0.05），and the levels of serum AChE and IL-17 in moderate group were higher than those in mild group（P<0.05）. The levels of serum AChE and IL-17 were negatively correlated with MoCA score in cognitive impairment group（r values were -0.311 and -0.480，P<0.01），and they were negatively correlated with MMSE score（r values were -0.349 and -0.447，P<0.01）. The areas under curves（AUC） of serum AChE and IL-17 single and combined determinations for the diagnosis of cognitive function impairment in HSE patients were 0.689，0.724 and 0.893，respectively. Conclusions Serum AChE and IL-17 levels in HSE patients are correlated with cognitive function impairment and can be used to assess the severity of cognitive function impairment.

Key words: Acetylcholinesterase, Interleukin-17, Herpes simplex virus, Viral encephalitis, Cognitive function impairment

中图分类号:

R446.1

贺龙, 王莎, 程利萍, 廖子蔚, 王东红. 血清AChE、IL-17与单纯疱疹病毒性脑炎患者认知功能障碍的相关性[J]. 检验医学, 2023, 38(8): 719-724.

HE Long, WANG Sha, CHENG Liping, LIAO Ziwei, WANG Donghong. Correlations of serum AChE and IL-17 in patients with herpes simplex encephalitis with cognitive function impairment[J]. Laboratory Medicine, 2023, 38(8): 719-724.

图/表 6

参考文献 22

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组别	例数	性别		年龄/岁	BMI/ （kg/m²）	文化程度/%				AChE/ （U/mL）	IL-17/ （pg/mL）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	小学/ [例（%）]	初中/ [例（%）]	高中/ [例（%）]	大学/ [例（%）]	AChE/ （U/mL）	IL-17/ （pg/mL）
轻度组	23	13	10	45.02±7.51	23.76±0.75	2 （8.70）	5（21.74）	8（34.78）	8（34.78）	66.05±1.39	15.35±0.49
中度组	30	19	11	45.12±7.09	23.80±0.80	4 （13.33）	14（46.67）	9（30.00）	3（10.00）	68.64±3.06^*	17.09±1.63^*
重度组	16	10	6	45.22±7.18	24.16±0.71	3 （18.75）	9（56.25）	2（12.50）	2（12.50）	71.72±0.47^*#	19.29±0.06^*#
统计值		0.277		0.004	1.597	10.496				31.666	58.776
P值		0.871		0.996	0.211	0.105				<0.01	<0.01

组别	例数	性别		年龄/岁	BMI/ （kg/m²）	文化程度/%				AChE/ （U/mL）	IL-17/ （pg/mL）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	小学/ [例（%）]	初中/ [例（%）]	高中/ [例（%）]	大学/ [例（%）]	AChE/ （U/mL）	IL-17/ （pg/mL）
轻度组	23	13	10	45.02±7.51	23.76±0.75	2 （8.70）	5（21.74）	8（34.78）	8（34.78）	66.05±1.39	15.35±0.49
中度组	30	19	11	45.12±7.09	23.80±0.80	4 （13.33）	14（46.67）	9（30.00）	3（10.00）	68.64±3.06^*	17.09±1.63^*
重度组	16	10	6	45.22±7.18	24.16±0.71	3 （18.75）	9（56.25）	2（12.50）	2（12.50）	71.72±0.47^*#	19.29±0.06^*#
统计值		0.277		0.004	1.597	10.496				31.666	58.776
P值		0.871		0.996	0.211	0.105				<0.01	<0.01

项目	AUC（95%CI^①）	最佳临界值	P值	敏感性/%	特异性/%	约登指数
AChE	0.689（0.611~0.760）	65.03 U/mL	<0.01	69.57	68.89	0.384 6
IL-17	0.724（0.648~0.792）	16.42 pg/mL	<0.01	73.91	72.22	0.461 3
联合检测模型	0.893（0.835~0.937）	0.51	<0.01	89.86	90.00	0.798 6

项目	AUC（95%CI^①）	最佳临界值	P值	敏感性/%	特异性/%	约登指数
AChE	0.689（0.611~0.760）	65.03 U/mL	<0.01	69.57	68.89	0.384 6
IL-17	0.724（0.648~0.792）	16.42 pg/mL	<0.01	73.91	72.22	0.461 3
联合检测模型	0.893（0.835~0.937）	0.51	<0.01	89.86	90.00	0.798 6