慢性阻塞性肺疾病伴认知功能障碍患者血清lipocalin-2表达及意义

目的分析血清脂质运载蛋白-2(lipocalin-2)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)稳定期伴认知障碍患者血清中的表达变化及其意义。 方法依据蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分，MoCA分值<26分者为认知受损，将43例COPD稳定期的患者分为认知障碍组23例及认知正常组20例，并选取20例健康体检者做对照组；采用酶联免疫吸附实验(ELISA)分别检测患者外周静脉血清脂质运载蛋白-2(lipocalin-2)水平；分析血清脂质运载蛋白-2与认知功能的相关性，根据血清lipocalin-2水平预测认知障碍的受试者工作特征(ROC)曲线。 结果与健康对照组相比(60.37±10.77)μg/ml，COPD稳定期伴认知障碍患者血清lipocalin-2水平(82.76±12.90)μg/ml显著增加(P<0.05)；与COPD稳定期认知正常组(69.70±11.51)μg/ml相比，认知功能障碍组血清lipocalin-2水平显著升高，差别有统计学意义(P<0.05)。Pearson相关分析结果显示血清lipocalin-2水平与MoCA评分呈负相关(r＝-0.749，P<0.001)；血清lipocalin-2水平预测COPD稳定期患者认知功能障碍的ROC曲线下面积分别为0.804(95%CI 0.664~0.945，P<0.001)。 结论血清lipocalin-2表达水平与COPD稳定期患者认知功能障碍密切相关。血清lipocalin-2水平检测可能成为COPD患者出现认知功能障碍的一个重要诊断指标。

Expression and Significance of Serum lipocalin-2 in Patients with chronic obstructive pulmonary disease with Cognitive Impairment

Objective To investigate the correlation and clinical significance of serum lipocalin-2 level with cognitive impairment in patients with the stable stage of chronic obstructive pulmonary disease(COPD).Methods According to the Montreal cognitive assessment(MoCA)scale standard for evaluation,a cutoff score of<26 defined as mild cognitive impairment(MCI).A total of 43 patients in the stable stage of COPD were divided into a cognitive impairment group(Cog I)(23 patients)and a cognitive normal group(Cog N)(20 patients),and 20 healthy Subjects as control group.The level of serum lipocalin-2 in each group was detected by enzyme-linked immunosorbent assay(ELISA),the correlation between lipocalin-2 and cognitive function was analyzed,and the ROC curve of cognitive impairment was predicted according to the level of lipocalin-2.Results Compared with the healthy control group(60.37±10.77)μg/ml,the serum level of lipocalin-2 in stable COPD patients with cognitive impairment(82.76±12.90)μg/ml was significant higher(P<0.05).Compared with than the cognitive normal group(69.70±11.51)μg/ml,the protein level of lipocalin-2 was increased in serum of stable COPD patients with cognitive impairment(P<0.05).Pearson line correlation revealed that the serum level of lipocalin-2 was negatively correlated with MoCA score(r=-0.749,P<0.001),The areas under ROC curve of serum lipocalin-2 level to predict cognitive dysfunction in the COPD patients was 0.804(95%CI 0.664-0.945,P<0.001).Conclusion The serum lipocalin-2 level is closely related to the cognitive dysfunction of stable COPD patients.The detection of serum lipocalin-2 level may be an important diagnostic index of cognitive dysfunction in COPD patients.