检测并分析血清S100β、缺血修饰白蛋白（IMA）、热休克蛋白70（HSP70）在脑小血管病认知功能损害中的表达及相关性。

选取河北医科大学第一医院2020年4月至2021年5月收治的120例脑小血管疾病患者，其中男性51例，女性69例，年龄55~80岁，平均（67.5±9.4）岁。依是否有认知功能障碍将患者分为无认知功能障碍的对照组和有认知功能障碍的研究组，各60例。研究组根据影像学改变分为3个亚组：脑白质病变组（WML组）、腔隙性梗死组（LI组）和WML+LI组。使用酶联免疫吸附法检测2组S100β、IMA、HSP70水平，根据蒙特利尔认知评估（MoCA）量表评估患者认知状况。将结果分析中P＜0.05的变量作为多因素条件对脑小血管病患者发生认知障碍进行logistic回归分析。

研究组患者血清中S100β表达高于对照组，IMA、HSP70水平、MoCA评分低于对照组，差异均有统计学意义（均P＜0.05）。与LI组相比，WML组、WML+LI组患者S100β水平升高，IMA、HSP70水平及MoCA评分降低，差异具有统计学意义（均P＜0.05）。与WML组相比，WML+LI患者S100β水平升高、MA、HSP70水平及MoCA评分降低，差异具有统计学意义（均P＜0.05）。Pearson相关性分析发现，S100β与IMA、HSP70、MoCA呈负相关（r=-0.560、-0.579、-0.635，均P＜0.001）；IMA与HSP70、MoCA评分呈正相关（r=0.504、0.645、0.584，均P＜0.001）；HSP70与MoCA评分呈正相关（r=0.564，P＜0.001）。多因素Logistic回归模型分析显示，S100β［OR（95%CI）=0.713（0.704~0.831）］、IMA［OR（95%CI）=0.744（0.726~0.864）］、HSP70［OR（95%CI）=0.335（0.787~0.768）］为脑小血管病认知功能损害的影响因素（均P＜0.05）。

随着患者病情加重，S100β水平逐渐升高、IMA、HSP70水平逐渐降低，与脑小血管病患者认知功能损害发展密切相关。

To investigate the expression of serum S100 β, ischemia-modified albumin (IMA), and heat shock protein 70 (HSP70) in cognitive impairment of patients with cerebral small vessel disease and to explore their clinical significance.

A total of 120 patients with cerebral small vessel disease admitted to the First Hospital of Hebei Medical University from April 2020 to May 2021 were selected, including 51 males and 69 females. The patient ranged in age from 55-80 years, with an average age of (67.5±9.4) years. The patients were divided into a control group without cognitive dysfunction or a research group with cognitive dysfunction, with 60 cases in each group. The research group was divided into 3 subgroups based on imaging changes: leukoencephalopathy group (WML group), lacunar infarction group (LI group), and WML+LI group. The levels of S100β, IMA, and HSP70 in both groups were detected by enzyme-linked adsorption method, and the cognitive status of patients was assessed according to the Montreal cognitive assessment (MoCA) scale. Variables with significant differences in the analysis were used as multivariate conditions for logistic regression analysis of cognitive impairment in patients with small cerebral vascular disease.

Serum S100β level in the research group was higher than that in the control group, while serum IMA and HSP70, and MoCA score were all lower than those in the control group (P＜0.05 for all). Compared with the LI subgroup, the levels of S100β in the WML and WML+LI subgroups were increased, and the levels of IMA, HSP70, and MoCA score were decreased (P＜0.05 for all). Compared with the WML subgroup, the level of S100β in the WML+LI group was increased, and the levels of MA, HSP70, and MoCA score were decreased (P＜0.05 for all). Pearson correlation analysis showed that S100β was negatively correlated with IMA, HSP70, and MoCA score (r=-0.560, -0.579, and -0.635, respectively, P＜0.001 for all); IMA was positively correlated with HSP70 and MoCA score (r=0.504, 0.645, and 0.584, P＜0.001 for all); HSP70 was positively correlated with MoCA score (r=0.564, P＜0.001). Multivariate logistic regression analysis showed that serum S100β [OR (95%CI)=0.713 (0.704-0.831)], IMA [OR (95%CI)=0.744 (0.726-0.864)], and HSP70 [OR (95%CI)=0.335 (0.787-0.768)] were factors affecting cognitive impairment in patients with cerebral small blood vessel disease (P＜0.05 for all).

With the aggravation of the disease, serum S100β level gradually increases, and serum IMA and HSP70 levels gradually decrease, which is closely related to the development of cognitive impairment in patients with small cerebral vascular disease.