人尿激肽原酶可降低急性缺血性脑卒中患者卒中后认知障碍的发生率。

Human urinary kallidinogenase decreases the incidence of post-stroke cognitive impairment in acute ischemic stroke patients.

机构信息

Department of Neurology, The First People's Hospital of Shenyang, 110041 Shenyang, Liaoning, China.

Department of Neurology, The First Afﬁliated Hospital of China Medical University, 110001 Shenyang, Liaoning, China.

出版信息

J Integr Neurosci. 2022 Apr 8;21(3):80. doi: 10.31083/j.jin2103080.

DOI:10.31083/j.jin2103080

PMID:35633161

Abstract

BACKGROUND

Post-stroke cognitive impairment (PSCI) is a common symptom of stroke and affects the quality of life and prognosis of stroke survivors. In our study, we evaluated the efficacy of Human urinary kallidinogenase (HUK) on cognitive function in acute ischemic stroke (AIS) patients, and discussed the role of cystatin C (CysC) in improving PSCI.

METHODS

We enrolled a retrospective cohort with prospective follow-up. From August 2020 to May 2021, 130 patients completed the final follow-up. Among them, 61 patients received HUK combined with basic treatment, which we defined as the HUK group, and 69 patients received basic treatment, which we defined as the control group. We compared the changes of CysC, urea nitrogen and creatinine levels after one week of treatment between the two groups. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) at 3-month after AIS.

RESULTS

No significant differences in demographic data and Laboratory tests between two groups before treatment. A total of 67 patients (51.5%) were diagnosed as PSCI at 3-month follow-up, among which, 25 patients were in the HUK group and 42 patients were in the control group. Compared with the control group (60.9%), the incidence of PSCI was significantly lower in the HUK group (41.0%). In addition, the serum CysC level after a week of treatment significantly decreased from baseline in HUK group ( = 0.037), in comparison, the serum CysC level in the control group was basically unchanged ( = 0.951). There was a significant negative correlation between MoCA score and the level of CysC after treatment ( = 0.003, = -0.373).

CONCLUSIONS

HUK can reduce the risk of PSCI at 3-month in AIS patients. The decrease of serum CysC level may be one of the mechanisms by which HUK reduces the incidence of PSCI.

摘要

背景

脑卒中后认知障碍（PSCI）是脑卒中的常见症状，影响脑卒中幸存者的生活质量和预后。在我们的研究中，我们评估了人尿激肽原酶（HUK）对急性缺血性脑卒中（AIS）患者认知功能的疗效，并探讨了胱抑素 C（CysC）在改善 PSCI 中的作用。

方法

我们进行了一项回顾性队列研究，并进行前瞻性随访。2020 年 8 月至 2021 年 5 月，共有 130 例患者完成了最终随访。其中，61 例患者接受 HUK 联合基础治疗，定义为 HUK 组，69 例患者接受基础治疗，定义为对照组。我们比较了两组患者治疗 1 周后 CysC、尿素氮和肌酐水平的变化。AIS 后 3 个月采用蒙特利尔认知评估量表（MoCA）评估认知功能。

结果

两组患者治疗前的人口统计学资料和实验室检查无统计学差异。共有 67 例（51.5%）患者在 3 个月随访时被诊断为 PSCI，其中 HUK 组 25 例，对照组 42 例。与对照组（60.9%）相比，HUK 组 PSCI 的发生率明显较低（41.0%）。此外，与治疗前相比，HUK 组治疗 1 周后血清 CysC 水平从基线显著下降（ = 0.037），而对照组血清 CysC 水平基本不变（ = 0.951）。治疗后 MoCA 评分与 CysC 水平呈显著负相关（ = 0.003， = -0.373）。