脑胶质瘤患者立体定向切除术前后认知功能变化及β-EP、3-NT预测认知功能障碍价值探讨

doi:10.19854/j.cnki.1008-2425.2023.01.0006

立体定向和功能性神经外科杂志 ›› 2023, Vol. 36 ›› Issue (1): 29-34.DOI: 10.19854/j.cnki.1008-2425.2023.01.0006

脑胶质瘤患者立体定向切除术前后认知功能变化及β-EP、3-NT预测认知功能障碍价值探讨

刘美霞, 周龙, 田仁富, 潘轲, 向春晖

445000 恩施恩施土家族苗族自治州中心医院神经内科(刘美霞);湖北恩施土家族苗族自治州中心医院神经外科(周龙, 田仁富,潘轲,向春晖)

收稿日期:2022-08-10 出版日期:2023-02-25 发布日期:2023-03-21
通讯作者: 周龙 w379190@163.com
基金资助:
湖北省卫生健康委员会医学科学研究课题计划项目(编号:WJ2019M102)

Changes of cognitive function before and after stereotactic resection in patients with Brain glioma and the value of β-EP and 3-NT in predicting cognitive dysfunction

Liu Meixia, Zhou Long, Tian Renfu, et al

1. Neurosurgery,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi,445000,China;
2. Department of Neurology,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi,445000,China

Received:2022-08-10 Online:2023-02-25 Published:2023-03-21

摘要/Abstract

摘要： 目的探讨脑胶质瘤(BG)患者立体定向切除术前后认知功能变化及β内啡肽(β-EP)、3-硝基络氨酸(3-NT)预测认知功能障碍(CD)的价值。方法选取我院2018年3月～2021年10月BG患者113例,均行立体定向切除术治疗,评估术前、术后2周认知功能(MoCA评分),根据MoCA评分变化分CD组、正常组。对比两组基线资料、术前、术后1d、术后2周β-EP、3-NT水平,分析CD独立影响因素,建立Logistic回归模型并进行评价,受试者工作特征曲线(ROC)分析β-EP、3-NT对CD的预测价值。结果 113例患者术后2周MoCA评分(27.31±1.03)分高于入院时MoCA评分(23.65±1.47)分(P＜0.05),CD发生率为25.66%;CD组病灶最大径、肿瘤分级为Ⅲ～Ⅳ级、术前癫痫者、术前、术后1 d、术后2周3-NT水平高于正常组,术前、术后1 d、术后2周β-EP水平低于正常组(P＜0.05);校正病灶最大径、肿瘤分级、术前癫痫后,3-NT、β-EP为CD的独立影响因素(P＜0.05);建立Logistic回归模型:logit(P)=4.603+0.384×术后1 d 3-NT-1.000×术后1 d β-EP,拟合度较好;β-EP、3-NT联合预测发生CD的AUC大于单一指标预测值(P＜0.05)。结论 BG患者经立体定向切除术后认知功能好转,但仍有部分患者术后发生CD,β-EP、3-NT联合预测BG患者发生CD具有较高的效能。

关键词: 脑胶质瘤, 立体定向切除术, 认知功能, 硝基酪氨酸, β内啡肽

Abstract: Objective To investigate the changes of cognitive function before and after stereotactic resection in patients with Brain glioma (BG) and the prediction of cognitive dysfunction (CD) by β-endorphin (β-EP) and 3-nitrotyrosine (3-NT) the value of.Methods A total of 113 patients with BG from March 2018 to October 2021 in our hospital were selected and all received stereotactic resection.The cognitive function (MoCA score) was evaluated before operation and 2 weeks after operation,and the patients were divided into CD group and normal group according to the change of MoCA score.The baseline data,preoperative,postoperative 1d,and 2 weeks postoperative β-EP and 3-NT levels were compared between the two groups.The independent influencing factors of CD were analyzed.Logistic regression model was established and evaluated.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of β-EP and 3-NT for CD.Results The MoCA score of 113 patients 2 weeks after operation of (27.31±1.03) was higher than that of (23.65±1.47) at admission(P＜0.05),and the incidence of CD was 25.66%.The largest diameter of the lesion,the tumor grade of grade Ⅲ-Ⅳ,the patients with preoperative epilepsy,the level of 3-NT before surgery,1d after surgery,and 2 weeks after surgery in the CD group were higher than those in the normal group,and the levels of β-EP before operation,1d after operation and 2 weeks after operation were lower than those in normal group (P＜0.05).After adjusting for the largest diameter of the lesion,tumor grade,and preoperative epilepsy,3-NT and β-EP were independent influencing factors of CD (P＜0.05).Logistic regression model was established:logit(P)=4.603+0.384×1d postoperative 3-NT-1.000×1d postoperative β-EP,and the fit was good.The AUC of β-EP and 3-NT combined to predict the occurrence of CD was greater than the predicted value of single index (P＜0.05).Conclusion Cognitive function of BG patients improved after stereotactic resection,but some patients still developed CD after operation.

Key words: Brain glioma, Stereotactic Resection, Cognitive Function, Nitrotyrosine, Beta Endorphins

中图分类号:

R739.4

刘美霞, 周龙, 田仁富, 潘轲, 向春晖. 脑胶质瘤患者立体定向切除术前后认知功能变化及β-EP、3-NT预测认知功能障碍价值探讨[J]. 立体定向和功能性神经外科杂志, 2023, 36(1): 29-34.

Liu Meixia, Zhou Long, Tian Renfu, et al. Changes of cognitive function before and after stereotactic resection in patients with Brain glioma and the value of β-EP and 3-NT in predicting cognitive dysfunction[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(1): 29-34.

参考文献

[1] Hua H,Zhang X,Mu H,et al.RVG29-modified docetaxel-loaded nanoparticles for brain-targeted glioma therapy[J].Int J Pharm,2018,543(1-2):179~189.
[2] Dube T,Kumar N,Bishnoi M,et al.Dual Blood-Brain Barrier-Glioma Targeting Peptide-Poly(levodopamine) Hybrid Nanoplatforms as Potential Near Infrared Phototheranostic Agents in Glioblastoma[J].Bioconjug Chem,2021,32(9):2014~2031.
[3] 李勃翰,于书卿,朱强,等.影响老年额叶胶质瘤认知功能的因素及手术治疗对认知功能的影响[J].国际神经病学神经外科学杂志,2020,47(1):27~30.
[4] 朱鸿宇.显微镜手术治疗脑胶质瘤的效果及对患者术后认知功能的影响[J].中国医药指南,2020,18(29):61~62.
[5] 李春明,姚红芳,潘康健.血清3-硝基酪氨酸水平与脑小血管病患者并发认知功能障碍的关系[J].山东医药,2021,61(16):61~64.
[6] 肖莉,张倩雨,马莹,等.氧化应激在肿瘤糖代谢中的作用研究[J].肿瘤,2018,38(9):901~906.
[7] 任德启,郭会军.补肾益智法对血管性痴呆大鼠学习记忆及其脑组织β-EP、SS含量的影响[J].四川中医,2004,22(5):24~25.
[8] 国家卫生健康委员会医政医管局.脑胶质瘤诊疗规范(2018年版)[J].中华神经外科杂志,2019,35(3):217~239.
[9] Bruijnen CJWH,Dijkstra BAG,Walvoort SJW,et al.Psychometric properties of the Montreal Cognitive Assessment (MoCA) in healthy participants aged 18-70[J].Int J Psychiatry Clin Pract,2020,24(3):293~300.
[10] 赵军,吴胜波,李品群,等.立体定向微创手术对脑胶质瘤患者近远期疗效和神经功能评分的影响[J].国际神经病学神经外科学杂志,2020,47(4):387~390.
[11] 刘宏志.立体定向微创手术治疗脑胶质瘤患者的临床效果及对患者Th1/Th2细胞因子的影响[J].实用癌症杂志,2020,35(11):1905~1908.
[12] 曹炜,王翠雪.神经外科脑胶质瘤患者发生术后谵妄的危险因素分析[J].中华现代护理杂志,2020,26(34):4763~4768.
[13] 尹健,张宏燕,王晓娜,等.右美托咪定联合利多卡因对颅脑肿瘤手术患者神经功能、认知功能的影响[J].河北医药,2020,42(21):3293~3296.
[14] 高军.神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病的疗效与NPY、β-EP、NSE及炎性因子的临床价值[J].中国妇幼保健,2019,34(13):3000~3003.
[15] Derbyshire E,Obeid R.Choline,Neurological Development and Brain Function:A Systematic Review Focusing on the First 1000 Days[J].Nutrients,2020,12(6):1731.
[16] 周丽娟,杨朴,郑道都,等.秋水仙素对脑胶质瘤细胞体外抑制和对海马神经元细胞缺氧/复氧保护作用的研究[J].中国免疫学杂志,2021,37(8):936~940.
[17] 雷颉,蔡峰,逯芳芳,等.肌细胞增强因子2C在胶质母细胞瘤中表达及其影响研究[J].神经解剖学杂志,2018,34(2):170~174.
[18] Ito T,Ogino K,Nagaoka K,et al.Relationship of particulate matter and ozone with 3-nitrotyrosine in the atmosphere[J].Environ Pollut,2018,236(1):948-952.
[19] Spiers JG,Chen HC,Bourgognon JM,et al.Dysregulation of stress systems and nitric oxide signaling underlies neuronal dysfunction in Alzheimer's disease[J].Free Radic Biol Med,2019,134(1):468~483.
[20] 陈利贞,王科,谢静,等.脑胶质瘤患者术前认知功能的影响因素分析[J].解放军医学院学报,2019,40(2):149~152.
[21] Ferrer-Sueta G,Campolo N,Trujillo M,et al.Biochemistry of Peroxynitrite and Protein Tyrosine Nitration[J].Chem Rev,2018,118(3):1338~1408.
[22] Schiavone S,Neri M,Maffione AB,et al.Increased iNOS and Nitrosative Stress in Dopaminergic Neurons of MDMA-Exposed Rats[J].Int J Mol Sci,2019,20(5):1242.

脑胶质瘤患者立体定向切除术前后认知功能变化及β-EP、3-NT预测认知功能障碍价值探讨

Changes of cognitive function before and after stereotactic resection in patients with Brain glioma and the value of β-EP and 3-NT in predicting cognitive dysfunction

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

本文评价

[1]	杜云, 王卫中, 刘梦, 姚萌萌. 异柠檬酸脱氢酶1R132H与同源框C10在脑胶质瘤组织的表达及其临床意义[J]. 立体定向和功能性神经外科杂志, 2023, 36(3): 135-140.
[2]	胡运新, 孙永奇, 蓝志科, 王浩月, 李璇, 钟勇康. 多导睡眠脑电分析图特征的变化与帕金森病患者认知功能障碍的关系分析[J]. 立体定向和功能性神经外科杂志, 2023, 36(2): 76-81.
[3]	孟少林, 王伟, 孟凡然, 冯会玉, 何晨曦, 徐伟, 高飞. 基于多模态核磁共振成像脑胶质瘤术后调强适形放疗对患者自主神经反应的影响[J]. 立体定向和功能性神经外科杂志, 2023, 36(1): 22-28.
[4]	杜云, 王卫中, 刘梦, 姚萌萌. Notch3与TIP30表达对脑胶质瘤患者预后评估价值[J]. 立体定向和功能性神经外科杂志, 2022, 35(5): 273-279.
[5]	陈欢, 郝璐, 王禄伟, 马景旭, 刘莹, 姜磊, 王红. 磁共振灌注加权成像联合NODDI技术对脑胶质瘤分级诊断的临床价值分析[J]. 立体定向和功能性神经外科杂志, 2022, 35(3): 142-146.
[6]	关沛, 曹娅妮. 基于ERAS的术中唤醒麻醉技术对脑胶质瘤患者肿瘤切除程度、术后语言及运动功能的影响[J]. 立体定向和功能性神经外科杂志, 2022, 35(3): 147-152.