【摘要】 目的 探讨睡眠质量及血清S100钙结合蛋白β亚单位(S100β)、可溶性CD40配体(sCD40L)水平与脑小血管病病情严重程度的关系。方法 根据影像学总负荷评分将60例脑小血管病患者分为重度病情组22例和轻-中度病情组38例。比较两组患者的一般临床资料、匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)评分、失眠严重指数(ISI)评分及S100β、sCD40L水平的差异。采用二元Logistic回归分析评价组间差异性指标与脑小血管病患者病情严重程度的关系。结果 重度病情组高血压病比率显著高于轻-中度病情组(P<0.05)。重度病情组ESS、ISI评分显著高于轻-中度病情组(均P<0.001)。重度病情组血清S100β、sCD40L水平显著高于轻-中度病情组(均P<0.001)。单因素Logistic回归分析显示，高血压、ESS评分、ISI评分、S100β、sCD40L与脑小血管病病情严重程度存在潜在相关性(均P<0.05)。多因素Logistic回归分析显示，脑小血管病患者ESS评分、ISI评分、S100β、sCD40L与病情严重程度密切相关(均P<0.05)。结论 脑小血管病患者嗜睡及失眠严重程度、S100β水平、sCD40L水平均与病情严重程度密切相关，关注睡眠状况及机体炎症可以更准确地评估脑小血管病病情。更多还原

【Abstract】 Objective To explore the relationship between sleep quality, serum S100 calcium-binding protein β subunit(S100β) level, soluble CD40 ligand(sCD40L) level and the severity of cerebral small vessel disease. Methods According to the total imaging load score, 60 cerebral small vessel disease patients were divided into severe disease group(22 cases) and mild-to-moderate disease group(38 cases). The general clinical data, Pittsburgh sleep quality index(PSQI), Epworth sleepiness scale(ESS) score, insomnia severity index(ISI) score and the levels of S100β and sCD40L were compared between the two groups. Binary Logistic regression analysis was used to evaluate the correlation between the difference index between the groups and the severity of the disease in patients with cerebral small vessel disease. Results The rate of hypertension in severe disease group was significantly higher than that in mild-to-moderate disease group(P<0.05). The ESS and ISI scores in severe disease group were significantly higher than those in mild-to-moderate disease group(all P<0.001). The levels of serum S100β and sCD40L in severe disease group were significantly higher than those in mild-to-moderate disease group(all P<0.001). Univariate Logistic regression analysis showed that hypertension, ESS score, ISI score, S100β level and sCD40L level were potentially correlated with the severity of cerebral small vessel disease(all P<0.05). Multivariate Logistic regression analysis showed that ESS score, ISI score, S100β level and sCD40L level were closely related to the severity of cerebral small vessel disease(all P<0.05). Conclusions The severity of sleepiness and insomnia and the levels of serum S100β and sCD40L in patients with cerebral small vessel disease are closely related to the severity of the disease. Paying attention to the sleep status and the body’s inflammatory state of patients is conducive to a more accurate assessment of the severity of cerebral small vessel disease.更多还原