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目的探讨急性颅脑损伤(TBI)病人血清胰岛素样生长因子-1(IGF-1)动态变化与认知功能障碍的相关性。方法收集86例急性TBI病人作为研究组,分别于伤后1、3、5、7、14 d检测病人血清IGF-1含量,伤后6个月采用蒙特利尔认知评估量表(MoCA)评估有无认知功能障碍,并比较各时间点血清IGF-1含量与MoCA评分的相关性。选取30例同期健康体检者作为对照组。结果根据MoCA评分评估,TBI伤后6个月存在认知功能障碍36例(41.86%),主要表现为视空间与执行、注意力和计算力、语言能力、抽象能力及延迟记忆方面的障碍。研究组血清IGF-1含量在伤后各时间点均显著低于对照组(P<0.05)。伤后1、3、5 d,认知功能障碍病人血清IGF-1含量均显著低于无认知功能障碍病人(P<0.05)。伤后1、3、5 d,研究组病人血清IGF-1含量与MoCA评分呈正相关(P<0.05)。结论 TBI后血清IGF-1含量动态变化与认知功能障碍密切相关。伤后早期的血清IGF-1水平能够预测TBI病人的认知功能预后。
Objective To investigate the relationship between serum insulin-like growth factor-1 (IGF-1) and cognitive dysfunction in patients with acute brain injury (TBI). Methods Totally 86 acute TBI patients were collected as the study group. Serum IGF-1 levels were measured at 1, 3, 5, 7, and 14 days after injury. Monocreate Cognitive Assessment Scale (MoCA) No cognitive dysfunction, and at each time point serum IGF-1 levels and MoCA score correlation. 30 healthy subjects were selected as the control group. Results According to the assessment of MoCA score, there were 36 cases (41.86%) of cognitive impairment at 6 months after TBI injury. The main manifestations were disturbance of visual space and performance, attention and calculation, language ability, abstraction ability and delayed memory. The level of serum IGF-1 in the study group was significantly lower than that in the control group at each time point after injury (P <0.05). At 1, 3 and 5 days after injury, serum IGF-1 levels in patients with cognitive impairment were significantly lower than those without cognitive impairment (P <0.05). At 1, 3 and 5 days after injury, the serum IGF-1 level in study group was positively correlated with MoCA score (P <0.05). Conclusion The dynamic changes of serum IGF-1 levels after TBI are closely related to cognitive dysfunction. Early serum IGF-1 levels predict the prognosis of cognitive function in patients with TBI.