摘要
目的探讨帕金森病(PD)患者血清脂质运载蛋白2(LCN2)、蛋白S基因(PROS1)水平变化及其与疾病分期、认知障碍的相关性。方法选取2019年1月至2022年12月该院诊治的PD患者120例为研究对象(PD组),参考改良版Hoehn-Yahr分级(H-Y分级),分为早期PD组(0~1.5级,n=50),中期PD组(>1.5~3.0级,n=39),晚期PD组(>3.0~5.0级,n=31)。以同期健康体检的60例体检健康者为对照组。检测两组血清LCN2、PROS1水平。比较不同PD疾病分期PD患者血清LCN2、PROS1水平差异。Spearman秩相关分析血清LCN2、PROS1水平与简易智力状态检查量表(MMSE),蒙特利尔认知评估量表(MoCA)及H-Y分级的相关性。多因素Logistic回归分析影响PD患者认知功能障碍的相关因素。绘制受试者工作特征(ROC)曲线分析血清LCN2、PROS1水平对PD患者认知障碍的评估价值。结果PD组血清LCN2、PROS1水平分别为(97.47±11.28)μg/L、(77.52±8.69)μg/L,明显高于对照组(40.15±6.22)μg/L、(32.49±4.37)μg/L,差异均有统计学意义(t=36.641、37.783,均P<0.05)。晚期PD组血清LCN2、PROS1水平高于早期、中期PD组,差异均有统计学意义(均P<0.05)。认知障碍组PD患者病程、血清LCN2、PROS1、H-Y分级均高于认知正常组患者,而MoCA评分、MMSE评分低于认知正常组,差异均有统计学意义(P<0.05)。血清LCN2、PROS1水平与MoCA评分,MMSE评分呈负相关(r=-0.634、-0.489,均P<0.05),与H-Y分级呈正相关(r=0.467、0.625,均P<0.05)。血清LCN2、PROS1是影响PD患者认知功能障碍的相关危险因素。血清LCN2、PROS1单独及联合对PD患者认知功能障碍预测的曲线下面积(AUC)为0.905(95%CI:0.868~0.955),0.803(95%CI:0.764~0.849),0.836(95%CI:0.770~0.867),血清LCN2、PROS1联合检测AUC明显高于单独检测,差异具有统计学意义(Z=5.558,4.974,均P<0.001)。结论PD患者血清LCN2、PROS1水平升高,与PD疾病分期、认知障碍有关,两者联合检测对PD患者认知障碍具有较高的评估价值。
Objective To investigate the changes of serum lipocalin-2(LCN2)and protein S gene(PROS1)levels in Parkinson′s disease(PD)patients and their correlation with disease staging and cognitive impairment.Methods A total of 120 PD patients diagnosed and treated in the hospital from January 2019 to December 2022 were selected as the study objects(PD group).According to the improved Hoehn-Yahr grading(H-Y grading),they were divided into early stage PD group(0-1.5 grades,n=50),mid stage PD group(>1.5-3.0 grades,n=39),and late stage PD group(>3.0-5.0 grades,n=31).60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Serum levels of LCN2 and PROS1 in both groups were detected.The differences in serum LCN2 and PROS1 levels among PD patients with different stages of PD were compared.The correlation between serum LCN2,PROS1 levels with the scores of the Simplified Mental State Examination(MMSE),Montreal Cognitive Assessment Scale(MoCA)and H-Y grading were analyzed by Spearman rank correlation analysis.Multivariate Logistic regression analysis was used to analyze the correlative factors affecting cognitive impairment in PD patients.The evaluation value of serum LCN2,PROS1 levels in PD patients with cognitive impairment were analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of LCN2 and PROS1 in the PD group were(97.47±11.28)μg/L,(77.52±8.69)μg/L,which were significantly higher than(40.15±6.22)μg/L and(32.49±4.37)μg/L in the control group,and the differences were statistically significant(t=36.641,37.783,P<0.05).The serum levels of LCN2 and PROS1 in late stage PD group were significantly higher than those in the early stage PD group and mid stage PD group,and the differences were statistically significant(all P<0.05).The course of disease,serum LCN2,PROS1 and H-Y grading of PD patients in the cognitive impairment group were higher than those in the cognitive normal group,while the MoCA score and MMSE score were lower than those in the cognitive normal group,and the differences were statistically significant(P<0.05).The levels of serum LCN2 and PROS1 were negatively correlated with MoCA scores and MMSE scores(r=-0.634,-0.489,P<0.05),and positively correlated with H-Y grading(r=0.467,0.625,P<0.05).Serum LCN2 and PROS1 were related risk factors affecting cognitive impairment in PD patients.The area under the curve(AUC)of serum LCN2,PROS1 alone and in combination for predicting cognitive impairment in PD patients was 0.905(95%CI:0.868-0.955),0.803(95%CI:0.764-0.849),0.836(95%CI:0.770-0.867).The AUC of combined detection of serum LCN2 and PROS1 was significantly higher than those of single detection,and the differences were statistically significant(Z=5.558,4.974,P<0.001).Conclusion The increase of serum LCN2 and PROS1 levels in PD patients are related to the disease staging of PD and cognitive impairment.The combined detection of the two has high evaluation value for cognitive impairment of PD patients.
作者
单树崇
吴召军
何清
SHAN Shuchong;WU Zhaojun;HE Qing(Department of Neurology,the First People′s Hospital of Xuzhou,Xuzhou,Jiangsu 221000,China)
出处
《国际检验医学杂志》
CAS
2024年第9期1068-1072,1079,共6页
International Journal of Laboratory Medicine
基金
江苏省卫生健康委员会科研项目(M2020075)。
