标题：阿尔茨海默病患者认知功能与外周血炎症因子的相关性

      作者：杨应环 1，陈思路 1，胡小勇 1，蒋颖 2，沙蓉 1    华东师范大学附属精神卫生中心老年科 1、精神科 2，上海 200335

      卷次： 2024年35卷10期

      【摘要】 目的 分析阿尔茨海默病(AD)患者认知功能与外周血炎症因子的相关性。方法 回顾性选取2019年1月至2023年1月华东师范大学附属精神卫生中心收治的120例AD患者作为AD组，同期选取年龄、性别相匹配的40例健康体检志愿者作为健康组。比较两组受检者的简易精神状态量表(MMSE)评分、白细胞介素-6(IL-6)、肿瘤坏死因子-α (TNF-α)、C反应蛋白(CRP)水平。根据临床痴呆评定量表(CDR)评分将120例AD患者分为轻度组(CDR评分 1分) 39例、中度组(CDR评分 2分) 41例和重度组(CDR评分 3分) 40例，比较不同痴呆程度AD患者的MMSE评分、IL-6、TNF-α、CRP水平，采用Pearson相关性分析外周血 IL-6、TNF-α、CRP水平与MMSE、CDR评分的相关性。结果 AD组患者的MMSE评分为(15.12±7.26)分，明显低于健康组的(28.55±0.41)分，外周血 IL-6、TNF-α水平分别为(7.06±1.22) pg/mL、(8.96±1.08) pg/mL，明显高于健康组的(3.64±0.36) pg/mL、(6.22±0.69) pg/mL，差异均有统计学意义(P<0.05)，AD组患者的外周血CRP水平为(3.35±0.76) mg/L，略高于健康组的(3.13±0.45) mg/L，但差异无统计学意义(P>0.05)；轻度组患者的MMSE评分为(24.16±1.13)分，明显高于中度组的(15.08±1.55)分和重度组的(6.34±1.02)分，中度组的MMSE评分明显高于重度组，差异均有统计学意义(P<0.05)；轻度组患者的外周血 IL-6、TNF-α水平分别为(3.99±0.41) pg/mL、(6.91±0.98) pg/mL，明显低于中度组的(5.91±0.58) pg/mL、(8.56±0.82) pg/mL和重度组的(11.24±1.29) pg/mL、(11.37±1.31) pg/mL，中度组的外周血 IL-6、TNF-α水平明显低于重度组，差异均有统计学意义(P<0.05)，轻度组患者的外周血CRP水平为(3.18±0.49) mg/L，略低于中度组的(3.25±0.52) mg/L和重度组的(3.62±1.53) mg/L，但三组患者外周血CRP水平比较差异无统计学意义(P>0.05)；Pearson相关性分析结果显示，外周血 IL-6、TNF-α水平与MMSE评分均呈负相关(P<0.05)，与 CDR评分呈正相关(P<0.05)；外周血 CRP水平与MMSE评分、CDR评分均无明显相关性(P>0.05)。结论 外周血 IL-6、TNF-α水平上升参与AD发生发展和患者认知功能损伤过程。
      【关键词】 阿尔茨海默病；认知功能；简易精神状态量表；白细胞介素-6；肿瘤坏死因子-α；C反应蛋白
      【中图分类号】 R749 【文献标识码】 A 【文章编号】 1003—6350（2024）10—1396—04

Correlation between cognitive function and peripheral blood inflammatory factors in patients with Alzheimer'sdisease.
YANG Ying-huan 1, CHEN Si-lu 1, HU Xiao-yong 1, JIANG Ying 2, SHA Rong 1. Department of Geriatrics 1,Department of Psychiatry 2, Mental Health Center Affiliated to East China Normal University, Shanghai 200335, CHINA
【Abstract】 Objective To analyze the correlation between cognitive function and peripheral blood inflammato-ry factors in patients with Alzheimer's disease (AD). Methods A total of 120 patients with AD in Mental Health CenterAffiliated to East China Normal University were retrospectively selected between January 2019 and January 2023 as ADgroup, and 40 healthy volunteers with matched age and gender who received physical examination were selected ashealthy group. The score of Mini-mental State Examination (MMSE) and levels of interleukin-6 (IL-6), tumor necrosisfactor-α (TNF-α) and C-reactive protein (CRP) were compared between the two groups. According to the Clinical De-mentia Rating (CDR), 120 AD patients were divided into mild group (CDR score of 1 point, 39 cases), moderate group(CDR score of 2 points, 41 cases), and severe group (CDR score of 3 points, 40 cases). The MMSE score and levels ofIL-6, TNF-α, and CRP were compared among AD patients with different dementia degrees. Pearson correlation analysiswas used to analyze the correlation of levels of peripheral blood IL-6, TNF-α and CRP with MMSE score and CDRscore. Results The MMSE score of patients in AD group was (15.12±7.26) points, significantly lower than (28.55±0.41) points in healthy group (P<0.05); the levels of peripheral blood IL-6 and TNF-α were (7.06±1.22) pg/mL and(8.96±1.08) pg/mL, significantly higher than (3.64±0.36) pg/mL and (6.22±0.69) pg/mL in healthy group (P<0.05). Theperipheral blood CRP level was slightly higher than that in healthy group: (3.35±0.76) mg/L vs (3.13±0.45) mg/L, P>0.05. The MMSE score in mild group with (24.16±1.13) points was significantly higher than (15.08±1.55) points in mod-erate group and (6.34±1.02) points in severe group, and the score was significantly higher in moderate group than severegroup (P<0.05). The peripheral blood IL-6 and TNF-α with (3.99±0.41) pg/mL and (6.91±0.98) pg/mL in mild groupwere significantly lower than (5.91±0.58) pg/mL and (8.56±0.82) pg/mL in moderate group and (11.24±1.29) pg/mL and(11.37±1.31) pg/mL in severe group, and the levels in peripheral blood in moderate group were significantly lower com-pared to those in severe group (P<0.05). The level of CRP in mild group with (3.18±0.49) mg/L was slightly lower than(3.25±0.52) mg/L in moderate group and (3.62±1.53) mg/L in severe group, but the level revealed no statistically signifi-cant difference among the three groups (P>0.05). Pearson correlation analysis showed that the levels of peripheral bloodIL-6 and TNF-α were negatively correlated with MMSE score (P<0.05), and were positively correlated with CDR score(P<0.05). The level of CRP in peripheral blood was not significantly correlated with MMSE score and CDR score (P>0.05). Conclusion The increases of IL-6 and TNF-α in peripheral blood are involved in the occurrence and develop-ment of AD and the process of cognitive impairment in patients.
      【Key words】 Alzheimer's disease; Cognitive function; Mini-mental State Examination; Interleukin-6; Tumor ne-crosis factor-α; C-reactive protein