缺血性脑白质病变患者血清S-100β蛋白水平表达及其临床意义

刘时华; 张超; 田志刚; 侯文哲; 钟平

doi:10.16766/j.cnki.issn.1674-4152.001724

缺血性脑白质病变患者血清S-100β蛋白水平表达及其临床意义

doi: 10.16766/j.cnki.issn.1674-4152.001724

安徽医科大学附属宿州医院神经内科，安徽宿州 234000

基金项目:

安徽省重点研究与开发项目 1804h08020258

宿州市科技计划攻关项目 SZ2017GG43

详细信息

通讯作者:
钟平，E-mail: Dr.zhongping@163.com

中图分类号: R743 R446
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-24
- 网络出版日期: 2022-02-19

Expression and clinical significance of serum S-100β protein in patients with white matter ischaemic lesions

Department of Neurology, Suzhou Municipal Hospital, Affiliated of Anhui Medical University, Suzhou, Anhui 234000, China

摘要

摘要: 目的探讨缺血性脑白质病变患者(white matter ischemic lesions, WMIL)患者血清S-100β蛋白的表达及其与WMIL的关系。方法选取2017年6月—2019年9月安徽医科大学附属宿州医院收治的经颅脑磁共振证实的WMIL患者为研究对象，依据Fazekas评定量表评定脑白质病变程度。选取同期年龄和性别相匹配的颅脑磁共振正常者为对照组(69例)。应用酶联免疫吸附法测定患者血清S-100β蛋白水平。比较2组患者临床资料和S-100β蛋白水平，分析血清S-100β蛋白与脑白质病变程度的关系及WMIL的影响因素。结果与对照组比较，WMIL组患者高血压比例(79.1% vs.42.0%)、糖尿病患者比例(34.8% vs.15.9%)、S-100β蛋白水平[(1.414±0.260) pg/mL vs.(0.961±0.316)pg/mL]显著高于对照组，差异均具有统计学意义(均P＜0.05)。WMIL组患者血清S-100β蛋白水平与Fazekas评分呈显著正相关(r=0.736，P＜0.001)。多因素logistic回归分析显示，高血压、糖尿病和S-100β蛋白水平升高是WMIL的独立危险因素(均P＜0.01)。结论血清S-100β蛋白在WMIL患者中表达水平升高，且与WMIL严重程度呈正相关，血清S-100β蛋白水平升高可能是WMIL的独立危险因素，其可能作为脑白质慢性损伤的生物学指标。
- 脑白质病变 /
- 缺血性 /
- S-100β蛋白 /
- 生物学标志物
Abstract: Objective To explore the expression level of serum S-100β protein in patients with white matter ischaemic lesions (WMIL) and its relationship with WMIL. Methods Patients with WMIL, as confirmed by craniocerebral magnetic resonance, from June 2017 to September 2019 were selected as the research subjects, and the degree of white matter lesions was evaluated on the basis of the Fazekas rating scale. Those with normal craniocerebral magnetic resonance matched with age and sex during the same period were selected as the control group. Serum S-100β protein concentrations were detected with enzyme-linked immunosorbent assays. The general clinical data and S-100β protein levels were compared between the two groups. Spearman rank correlation was used to analyse the relationship between the serum S-100β protein level and degree of white matter lesions, and multivariate Logistic regression was used to analyse the influencing factors of WMIL. Results Compared with the control group, the proportion of patients with hypertension (79.1% vs. 42.0%, P < 0.001), the proportion of patients with diabetes (34.8% vs. 15.9%, P=0.006) and the level of S-100β protein [(1.414±0.260) pg/mL vs. (0.961±0.316) pg/mL, P < 0.001] in the WMIL group were significantly higher, and the differences were statistically significant. The serum S-100β protein level of patients in WMIL group was significantly and positively correlated with the Fazekas score (r=0.736, P < 0.001). Multivariate logistic regression analysis showed that hypertension, diabetes and elevated S-100β protein levels were independent risk factors for WMIL (all P < 0.01). Conclusion The expression level of serum S-100β protein is increased in WMIL patients and positively correlated with the severity of WMIL. The elevated serum S-100β protein level might be an independent risk factor for WMIL, which might be an effective biological marker of chronic white matter damage.
- White matter lesions /
- Ischaemic /
- S-100β protein /
- Biological marker

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表 1 2组研究对象临床资料及S-100β蛋白水平比较(x±s)

组别	例数	年龄 (岁)	性别[例(%)]		高血压 [例(%)]	2型糖尿病 [例(%)]	冠心病 [例(%)]	TC[M(P₂₅，P₇₅), mmol/L]
组别	例数	年龄 (岁)	男性	女性	高血压 [例(%)]	2型糖尿病 [例(%)]	冠心病 [例(%)]	TC[M(P₂₅，P₇₅), mmol/L]
WMIL组	115	56.00±6.27	60(52.2)	55(47.8)	91(79.1)	40(34.8)	11(9.6)	4.10(3.42, 4.38)
对照组	69	54.00±3.76	41(59.4)	28(40.6)	29(42.0)	11(15.9)	7(10.1)	4.34(3.67, 5.07)
统计量		1.946^a	0.915^b		26.169^b	7.641^b	0.016^b	-1.826^c
P值		0.063	0.339		＜0.001	0.006	0.898	0.068

组别	例数	TG[M(P₂₅，P₇₅), mmol/L]	LDL (mmol/L)	HDL (mmol/L)	Hcy (μmol/L)	CRP (mg/L)	HbA1c (%)	S-100β蛋白 (pg/mL)
WMIL组	115	1.29(0.98, 1.74)	1.18±0.35	2.13±0.75	19.49±4.82	3.86±0.56	6.98±1.42	1.414±0.260
对照组	69	1.43(1.02, 2.15)	1.16±0.28	2.19±0.68	17.62±2.98	3.25±0.46	6.14±1.37	0.961±0.316
统计量		-1.753^c	0.251^a	-0.545^a	0.032^a	0.736a	-6.674^a	10.016^a
P值		0.080	0.802	0.586	0.984	0.312	0.171	＜0.001
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 WMIL影响因素的多因素logistic回归分析

变量	B	SE	Wald χ²	P值	OR值	95% CI
高血压	-3.410	0.701	23.664	＜0.001	0.033	0.008~0.131
糖尿病	-1.666	0.633	6.935	0.008	0.189	0.055~0.653
S-100β蛋白	5.739	1.129	25.849	＜0.001	310.816	34.013~2 840.307

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参考文献(24)

[1]	PANTONI L, FIERINI F, POGGESI A. Impact of cerebral white matter changes on functionality in older adults: An overview of the LADIS Study results and future directions[J]. Geriatr Gerontol Int, 2015, 15(Suppl 1): 10-16. doi: 10.1111/ggi.12665/pdf
[2]	CHUTINET A, ROST N S. White matter disease as a biomarker for long-term cerebrovascu WMILr disease and dementia[J]. Curr Treat Options Cardiovasc Med, 2014, 16(3): 292. doi: 10.1007/s11936-013-0292-z
[3]	DOIT, SHIMADA H, MAKIZAKO H, et al. Effects of white matter lesions on trunk stability during dual-task walking among older adults with mild cognitive impairment[J]. Age (Dordr), 2015, 37(6): 120. doi: 10.1007/s11357-015-9858-x
[4]	RYU W S, WOO S H, SCHELLINGERHOUT D, et al. Stroke outcomes are worse with larger leukoaraiosis volumes[J]. Brain, 2017, 140(1): 158-170. doi: 10.1093/brain/aww259
[5]	CRISTÓVÀO J S, MORRIS V K, CARDOSO I, et al. The neuronal S-100β protein is a calcium-tuned suppressor of amyloid-β aggregation[J]. Sci Adv, 2018, 4(6): 1702. doi: 10.1126/sciadv.aaq1702
[6]	QIN B, PANICKAR K S, ANDERSON R A, et al. Cinnamon polyphenols attenuate the hydrogen peroxide-induced down regulation of S-100 beta secretion by regulating sirtuin 1 in C6 rat glioma cells[J]. Life Sci, 2014, 102(1): 72-79. doi: 10.1016/j.lfs.2014.02.038
[7]	LIU W, HUO X, LIU D, et al. S-100βprotein in heavy metal-related child attention-deficit hyperactivity disorder in an informal e-waste recycling area[J]. Neurotoxicology, 2014, 45: 185-191. doi: 10.1016/j.neuro.2014.10.013
[8]	GILSTON B A, SKAAR E P, CHAZIN W J, et al. Binding of transition metals to S-100 proteins[J]. Sci China Life Sci, 2016, 59(8): 792-801. doi: 10.1007/s11427-016-5088-4
[9]	WANG F, ZOU Z R, YUAN D, et al. Correlation between serum S100β protein levels and cognitive dysfunction in patients with cerebral small vessel disease: a case-control study[J]. Biosci Rep, 2017, 37(2): BSR20160446. doi: 10.1042/BSR20160446
[10]	ERCOLE A, THELIN E P, HOLST A, et al. Kinetic modelling of serum S100b after traumatic brain injury[J]. BMC Neurol, 2016, 16: 93. doi: 10.1186/s12883-016-0614-3
[11]	KOH S X, LEE J K. S100B as a marker for brain damage and blood-brain barrier disruption following exercise[J]. Sports Med, 2014, 44(3): 369-385. doi: 10.1007/s40279-013-0119-9
[12]	BRESNICK A R. S100 proteins as therapeutic targets[J]. Biophys Rev, 2018, 10(6): 1617-1629. doi: 10.1007/s12551-018-0471-y
[13]	LI K, JIA J, WANG Z, et al. Elevated Serum Levels of NSE and S-100β correlate with increased risk of acute cerebral infarction in Asian populations[J]. Med Sci Monit, 2015, 21: 1879-1888. doi: 10.12659/MSM.893615
[14]	DIMOPOULOS C, DAMASKOS C, PAPADAKIS M, et al. Expression of S-100βprotein in ischemia/reperfusion-induced brain injury after cyclosporine therapy: a biochemical serum marker with prognostic value?[J]. Med Sci Monit, 2019, 25: 1637-1644. doi: 10.12659/MSM.912810
[15]	ERCOLE A, THELIN E P, HOLST A, et al. Kinetic modelling of serum S-100βafter traumatic brain injury[J]. BMC Neurol, 2016, 16: 93. doi: 10.1186/s12883-016-0614-3
[16]	LU Y L, WANG R, HUANG H T, et al. Association of S100B polymorphisms and serum S100B with risk of ischemic stroke in a Chinese population[J]. Sci Rep, 2018, 8(1): 971. doi: 10.1038/s41598-018-19156-w
[17]	KANAVAKI A, SPENGOS K, MORAKI M, et al. Serum Levels of S100β and NSE proteins in patients with non-transfusion-dependent thalassemia as biomarkers of brain ischemia and cerebral vasculopathy[J]. Int J Mol Sci, 2017, 18(12): 2724. doi: 10.3390/ijms18122724
[18]	RENSMA S P, VAN SLOTEN T T, LAUNER L J, et al. Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: a systematic review and meta-analysis[J]. Neurosci Biobehav Rev, 2018, 90: 164-173. doi: 10.1016/j.neubiorev.2018.04.003
[19]	BLAIR G W, HERNANDEZ M V, THRIPPLETON M J, et al. Advanced neuroimaging of cerebral small vessel disease[J]. Curr Treat Options Cardiovasc Med, 2017, 19(7): 56. doi: 10.1007/s11936-017-0555-1
[20]	黄瑞, 曹红. 缺血性脑白质疏松症病变部位危险因素分析[J]. 中国现代神经疾病杂志, 2018, 18(11): 830-836. doi: 10.3969/j.issn.1672-6731.2018.11.013
[21]	王晓霞, 徐燕. 原发性高血压患者24 h动态血压变异性与脑白质病变的相关性研究[J]. 中国实用医刊, 2019, 46(7): 89-91. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG201909006.htm
[22]	方立, 袁学谦, 张莉峰, 等. 血压变异干预策略对高血压脑白质疏松、预后卒中及认知的影响[J]. 中国现代医学杂志, 2019, 29(13): 103-108. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXDY201913020.htm
[23]	李复兴, 王荔. 脑白质病变与糖化血红蛋白及糖尿病年限的相关性研究[J]. 临床医药实践, 2015, 24(9): 695-698. https://www.cnki.com.cn/Article/CJFDTOTAL-SXLC201509021.htm
[24]	罗彦妮, 覃冬华, 钟良, 等. 缺血性脑白质病变患者发生认知功能障碍的影响因素分析[J]. 广西医学, 2018, 40(12): 1299-1301. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX201812009.htm