Relationship between peripheral blood levels of Claudin⁃5, NPAR, Nrf2 and depression severity as well as cognitive impairment in patients with post⁃ischemic stroke depression

BAI Lu; MA Haifeng; ZHAI Xiuzhen; SUN Jian; WANG Gang; JING Yonghui

doi:10.14188/j.1671-8852.2025.0290

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Relationship between peripheral blood levels of Claudin⁃5, NPAR, Nrf2 and depression severity as well as cognitive impairment in patients with post⁃ischemic stroke depression

更新时间：2026-11-06

- Relationship between peripheral blood levels of Claudin⁃5, NPAR, Nrf2 and depression severity as well as cognitive impairment in patients with post⁃ischemic stroke depression
- Medical Journal of Wuhan University Vol. 46, Issue 12, Pages: 1634-1638(2025)
- 作者机构：
  
  河北北方学院附属第一医院神经内科河北张家口 075000
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2025.0290
  CLC： R143.4
- Received：27 March 2024，
  
  Published：25 December 2025
- 稿件说明：
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白璐,马海峰,翟秀珍等.外周血Claudin‑5、NPAR、Nrf2水平与缺血性脑卒中后抑郁患者抑郁程度及认知功能损害的关系[J].武汉大学学报（医学版）,2025,46(12):1634-1638.

BAI Lu,MA Haifeng,ZHAI Xiuzhen,et al.Relationship between peripheral blood levels of Claudin⁃5, NPAR, Nrf2 and depression severity as well as cognitive impairment in patients with post⁃ischemic stroke depression[J].Medical Journal of Wuhan University,2025,46(12):1634-1638.
白璐,马海峰,翟秀珍等.外周血Claudin‑5、NPAR、Nrf2水平与缺血性脑卒中后抑郁患者抑郁程度及认知功能损害的关系[J].武汉大学学报（医学版）,2025,46(12):1634-1638. DOI： 10.14188/j.1671-8852.2025.0290.

BAI Lu,MA Haifeng,ZHAI Xiuzhen,et al.Relationship between peripheral blood levels of Claudin⁃5, NPAR, Nrf2 and depression severity as well as cognitive impairment in patients with post⁃ischemic stroke depression[J].Medical Journal of Wuhan University,2025,46(12):1634-1638. DOI： 10.14188/j.1671-8852.2025.0290.

摘要

目的

探讨外周血紧密连接蛋白‑5（Claudin‑5）、中性粒细胞百分比与白蛋白的比值（NPAR）、转录因子E2相关因子2（Nrf2）水平与缺血性脑卒中（IS）后抑郁患者抑郁程度及认知功能损害的关系。

方法

选取2022年1月—2024年12月治疗的IS后抑郁患者106例，ELISA检查Claudin‑5、Nrf2水平，计算NPAR，Logistic回归分析患者认知功能损害的影响因素，ROC曲线分析Claudin‑5、NPAR、Nrf2对患者认知功能损害的预测价值，Spearman及Pearson法分析Claudin‑5、NPAR、Nrf2水平与患者抑郁程度及蒙特利尔认知评估量表（MoCA）评分的相关性。

结果

Claudin‑5与抑郁程度负相关（

=-0.534，

0.05），NPAR、Nrf2水平与抑郁程度呈正相关（

=0.512、0.5

33；

0.05）。认知障碍组的Claudin‑5水平显著低于非障碍组，Claudin‑5为影响患者认知障碍的保护因素，与MoCA评分呈正相关（

=0.498，

0.05）；认知障碍组的NPAR、Nrf2水平显著高于非障碍组，NPAR、Nrf2水平为影响患者认知障碍的危险因素（

0.05），与MoCA评分呈负相关（

=-0.472、-0.489，

0.05）；外周血Claudin‑5、NPAR、Nrf2联合显著优于Claudin‑5（

=3.144，

=0.002）、NPAR（

=2.874，

=0.004）、Nrf2（

=3.379，

=0.001）单独预测IS后认知障碍。

结论

IS后抑郁患者外周血Claudin‑5、NPAR、Nrf2与抑郁程度具有一定关系，对认知障碍具有一定预测价值。

Abstract

Objective

To explore the relationship between peripheral blood levels of Claudin⁃5

neutrophil⁃to⁃albumin ratio (NPAR)

and nuclear factor E2⁃related factor 2 (Nrf2)

and both depression severity and cognitive impairment in patients with post⁃ischemic stroke depression (IS).

Methods

From January 2022 to December 2024

106 patients with depression after IS were included in the study. ELISA was used to detect levels of Claudin‑5 and Nrf2 in peripheral blood

and the NPAR was calculated. Logistic regression was used to explore the influencing factors of cognitive impairment in patients. ROC curves were plotted to explore the predictive value of peripheral blood Claudin‑5

NPAR

and Nrf2 for cognitive impairment in patients. Spearman and Pearson correlation analyses were used to explore the correlation between Claudin‑5

NPAR

Nrf2 and the degree of depression and Montreal Cognitive Assessment (MoCA) scores.

Results

Compared with the mild depression group

the moderate and severe groups showed lower Claudin‑5 levels. Claudin‑5 was negatively correlated with the degree of depression (

=-0.534

0.05); while NPAR and Nrf2 were positively correlated with the degree of depression (

=0.512

0.533;

0.05). Claudin‑5 was a protective factor for cognitive function

and a positive correlation was found between Claudin‑5 and MoCA scores (

=0.498

0.05)

while NPAR and Nrf2 were risk factors for cognitive impairment (

0.05)

and NPAR and Nrf2 were negatively correlated with MoCA scores (

=-0.472

-0.489;

0.05). The combination of peripheral blood Claudin⁃5

NPAR

and Nrf2 demonstrated significantly superior predictive performance for post⁃ischemic stroke cognitive impairment compared to Claudin⁃5 alone (

=3.144

=0.002)

NPAR alone (

=2.874

=0.004)

or Nrf2 alone (

=3.379

=0.001).

Conclusion

Claudin‑5

NPAR

and Nrf2 in the peripheral blood of patients with depression IS are related to the degree of depression

and have certain predictive value for cognitive impairment.

关键词

Keywords

references

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BAI Lu

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Related Institution

Dept. of Neurology, The First Affiliated Hospital of Hebei North University

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