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

doi:10.19854/j.cnki.1008-2425.2023.01.0006

Abstract

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

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

CLC Number:

R739.4

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.

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.

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