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

白璐; 马海峰; 翟秀珍; 孙健; 王刚; 景永慧

doi:10.14188/j.1671-8852.2025.0290

您当前的位置：

首页 >

文章列表页 >

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

临床医学研究 | 更新时间：2026-11-06

- 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
- 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
- 武汉大学学报（医学版） 2025年46卷第12期页码：1634-1638
- 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：
  
  白璐，女，1997—，主要从事脑卒中方面工作研究， E‑mail：18703331578@163.com
  马海峰，女，1984—，主管护师，主要从事脑卒中方面的研究，E‑mail：742296767@qq.com
  翟秀珍，女，1967—，主任医师，教授，主要从事脑卒中方面的研究,E‑mail:1405734920@qq.com
- 基金信息：
  
  河北省2023年度医学科学研究课题计划(20231410);张家口市2024年市级科技计划自筹经费项目(2421033D)
- DOI：10.14188/j.1671-8852.2025.0290
  中图分类号： R143.4
- 收稿：2024-03-27，
  
  纸质出版：2025-12-25
- 稿件说明：
移动端阅览
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

RICE D R , OKENG'O K , MASSAWE E , et al . Efficacy of fluoxetine for post‑ischemic stroke depression in Tanzania [J ] . J Stroke Cerebrovasc Dis , 2022 , 31 ( 1 ): 106181 .

FENG Y , LI X B , WANG J , et al . Pyruvate kinase M2 (PKM2) improve symptoms of post‑ischemic stroke depression by activating VEGF to mediate the MAPK/ERK pathway [J ] . Brain Behav , 2022 , 12 ( 1 ): e2450 .

ZHANG Y J , XIA X S , ZHANG T , et al . Relation between sleep disorders and post‑stroke cognitive impairment [J ] . Front Aging Neurosci , 2023 , 15 : 1036994 .

YU P , LI Y Y , ZHONG G L , et al . Claudin‑5 affects endothelial autophagy in response to early hypoxia [J ] . Front Physiol , 2021 , 12 : 737474 .

LIU C F , CHIEN L W . Predictive role of neutrophil‑percentage‑to‑albumin ratio (NPAR) in nonalcoholic fatty liver disease and advanced liver fibrosis in nondiabetic US adults: Evidence from NHANES 2017‑2018 [J ] . Nutrients , 2023 , 15 ( 8 ): 1892 .

WANG L N , LIU L , LIU X J , et al . The association between neutrophil percentage‑to‑albumin ratio (NPAR) and depression among US adults: A cross‑sectional study [J ] . Sci Rep , 2024 , 14 ( 1 ): 21880 .

WANG L , ZHANG X , XIONG X X , et al . Nrf2 regulates oxidative stress and its role in cerebral ischemic stroke [J ] . Antioxidants , 2022 , 11 ( 12 ): 2377 .

KONG X Y , LYU W Y , LIN X J , et al . Itaconate alleviates anesthesia/surgery‑induced cognitive impairment by activating a Nrf2‑dependent anti‑neuroinflammation and neurogenesis via gut‑brain axis [J ] . J Neuroinflammation , 2024 , 21 ( 1 ): 104 .

中国国家卫生健康委员会急诊医学质控中心 , 中国医师协会急诊医师分会 , 世界中医药学会联合会急症专业委员会 . 中国急性缺血性脑卒中急诊诊治专家共识 [J ] . 中国急救医学 , 2018 , 38 ( 4 ): 281 ‑ 287 .

Quality Control Center of Emergency Medicine of the National Health Commission of China , Emergency Physicians Branch of China Medical Doctors' Association , and Emergency Committee of the World Federation of Societies of Traditional Chinese Medicine . Expert consensus on emergency diagnosis and treatment of acute ischemic stroke in China [J ] . Chin J Crit Care Med , 2018 , 38 ( 4 ): 281 ‑ 287 .

袁刚 , 赵晋 , 郑冬 , 等 . 抑郁自评量表和贝克抑郁量表区分抑郁症严重程度的准确度 [J ] . 神经疾病与精神卫生 , 2021 , 21 ( 12 ): 868 ‑ 873 .

YUAN G , ZHAO J , ZHENG D , et al . Study on distinguishing the severity of depression with self‑rating depression scale and beck depression inventory [J ] . J Neurosci Ment Health , 2021 , 21 ( 12 ): 868 ‑ 873 .

ZHENG D H , VAUGHN S , GOULD M , et al . Bibliometric analysis of depression in post‑stroke patients [J ] . Int J Emerg Med , 2024 , 17 ( 1 ): 139 .

LU W Z , WEN J Y . Neuroinflammation and post‑stroke depression: Focus on the microglia and astrocytes [J ] . Aging Dis , 2024 , 16 ( 1 ): 394 ‑ 407 .

SLOANE K L , HAMILTON R H . Transcranial direct current stimulation to ameliorate post‑stroke cognitive impairment [J ] . Brain Sci , 2024 , 14 ( 6 ): 614 .

LU Q Y , YU A Q , PU J C , et al . Post‑stroke cognitive impairment: Exploring molecular mechanisms and omics biomarkers for early identification and intervention [J ] . Front Mol Neurosci , 2024 , 17 : 1375973 .

YANG Z G , LIN P P , CHEN B , et al . Autophagy alleviates hypoxia‑induced blood‑brain barrier injury via regulation of CLDN5 (claudin 5) [J ] . Autophagy , 2021 , 17 ( 10 ): 3048 ‑ 3067 .

TACHIBANA K , HIRAYAMA R , SATO N , et al . Association of plasma claudin‑5 with age and Alzheimer's disease [J ] . Int J Mol Sci , 2024 , 25 ( 3 ): 1419 .

ZHU N , WEI M D , YUAN L G , et al . Claudin‑5 relieves cognitive decline in Alzheimer's disease mice through suppression of inhibitory GABAergic neurotransmission [J ] . Aging , 2022 , 14 ( 8 ): 3554 ‑ 3568 .

DENG L F , WANG T , DUAN Y , et al . Neutrophil percentage‑to‑albumin ratio is a potential marker of intravenous immunoglobulin resistance in Kawasaki disease [J ] . Sci Rep , 2024 , 14 ( 1 ): 15232 .

ZHANG H P , WU T , TIAN X L , et al . High neutrophil percentage‑to‑albumin ratio can predict occurrence of stroke‑associated infection [J ] . Front Neurol , 2021 , 12 : 705790 .

FAN D , WANG T F , XIANG J X , et al . Neutrophil percentage‑to‑albumin ratio is associated with cognitive function in adults aged over 60 years: An analysis of data from the NHANES 2011‑2014 [J ] . J Alzheimers Dis , 2024 , 102 ( 1 ): 150 ‑ 161 .

LIN Z D , XU G Y , LU X , et al . Chondrocyte‑targeted exosome‑mediated delivery of Nrf2 alleviates cartilaginous endplate degeneration by modulating mitochondrial fission [J ] . J Nanobiotechnology , 2024 , 22 ( 1 ): 281 .

FAN W , CHEN H P , LI M , et al . NRF2 activation ameliorates blood‑brain barrier injury after cerebral ischemic stroke by regulating ferroptosis and inflammation [J ] . Sci Rep , 2024 , 14 ( 1 ): 5300 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

早年应激引起大鼠性别差异性行为改变

握力在社区老年人睡眠质量与认知功能间的中介效应

不同运动类型对主观记忆抱怨老年人认知功能效果的网状Meta分析

构建电视胸腔镜继发术后认知功能障碍的风险预测模型

ADAMTS4在急性肺损伤/急性呼吸窘迫综合征中的研究进展