[1]郑德泉,江 华,林锦标,等.帕金森病患者血清NPASDP-4，MBP 水平表达与认知功能障碍及严重程度的诊断价值研究[J].现代检验医学杂志,2024,39(03):17-23+59.[doi:10.3969/j.issn.1671-7414.2024.03.003]
　ZHENG Dequan,JIANG Hua,LIN Jinbiao,et al.Study on the Diagnostic Value of Serum NPASDP-4 and MBP Level Expression with Cognitive Dysfunction and Severity in Parkinson’s Disease Patients[J].Journal of Modern Laboratory Medicine,2024,39(03):17-23+59.[doi:10.3969/j.issn.1671-7414.2024.03.003]
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帕金森病患者血清NPASDP-4，MBP 水平表达与认知功能障碍及严重程度的诊断价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年03期
页码:
17-23+59
栏目:
论著
出版日期:
2024-05-15

文章信息/Info

Title:
Study on the Diagnostic Value of Serum NPASDP-4 and MBP Level Expression with Cognitive Dysfunction and Severity in Parkinson’s Disease Patients
文章编号:
1671-7414（2024）03-017-08
作者:
郑德泉; 江 华; 林锦标; 韩玉惠; 李清金; 黄 巍; 吴义森
[中国人民解放军联勤保障部队第九○九医院（厦门大学附属东南医院），福建漳州 363000]
Author(s):
ZHENG Dequan;  JIANG Hua;  LIN Jinbiao;  HAN Yuhui;  LI Qingjin;  HUANG Wei;  WU Yisen
[The 909th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China (Southeast Hospital Affiliated to Xiamen University)， Fujian Zhangzhou 363000，China]
关键词:
认知功能障碍; 帕金森病; 神经元PAS 结构域蛋白4; 髓鞘碱性蛋白
分类号:
R749.16；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.03.003
文献标志码:
A
摘要:
目的 探讨帕金森病患者血清神经元PAS 结构域蛋白4（neuronal Per-Arnt-Sim domain protein 4,NPASDP-4）、髓鞘碱性蛋白（myelin basic protein ，MBP）水平表达与认知功能障碍（cognitive impairment，CI）及严重程度的诊断价值研究。方法 选取中国人民解放军联勤保障部队第九〇九医院收治的138 例帕金森病患者为帕金森病组，同期该院体检中心的健康体检者69 例为健康对照组，并根据是否发生CI 以及其严重程度进一步将帕金森病组患者分为认知功能正常组（n=55）、轻度CI 组（n=51）和痴呆组（n=32）。收集受试者一般资料；ELISA 法检测血清NPASDP-4 和MBP 水平；相关性分析采用Spearman 等级相关或Pearson 线性相关；诊断价值分析采用ROC 曲线；影响因素分析采用多因素Logistic 回归。结果 与健康对照组比较，帕金森病组血清NPASDP-4（6.75±0.48ng/ml vs2.38±0.31ng/ml），MBP（8.34±0.65μg/L vs 3.54±0.42μg/L）水平升高，差异具有统计学意义（t=68.751，55.761，均P ＜ 0.05）。认知功能正常组、轻度CI 组、痴呆组H-Y 分期比较，差异有统计学意义（χ2=7.788，P ＜ 0.05）。UPDRS- Ⅲ评分与认知功能正常组（41.95±10.36 分）比较，轻度CI 组（47.92±11.63 分）、痴呆组（50.78±13.69 分）评分升高，差异具有统计学意义（H=6.672，均P ＜ 0.05）。认知功能正常组、轻度CI 组、痴呆组病程（4.28±0.54，4.71±0.58 和5.16±0.63 年）及血清NPASDP-4（5.89±0.40，6.83±0.55 和8.12±0.54ng/ml），MBP（6.65±0.56，8.94±0.69和10.27±0.70μg/L）水平依次显著升高（H=24.114，207.950，355.594，均P ＜ 0.05），MMSE 评分（28.47±0.94，24.51±1.35 和17.09±2.57 分）、MoCA 评分（27.45±1.03，20.18±1.92 和11.75±2.53 分）、GPCOG 总分（13.47±0.69，10.25±1.04 和8.97±0.82 分）依次显著降低（H=515.005，775.933，327.584，均P ＜ 0.05），差异具有统计学意义。帕金森病患者血清NPASDP-4，MBP 水平均与病程（r=0.316，0.358）、H-Y 分期（r=0.345，0.384）、UPDRS- Ⅲ评分（r=0.371，0.396）呈显著正相关（P ＜ 0.05），与MMSE 评分（r=-0.468，-0.517）、MoCA 评分（r=-0.504，-0.569）、GPCOG 总分（r=-0.527，-0.538）呈显著负相关（均P ＜ 0.05）。血清NPASDP-4，MBP 水平及二者联合诊断帕金森病患者CI 的曲线下面积（AUC）分别为0.850，0.930 和0.960，诊断帕金森病患者CI 严重程度的AUC 分别为0.866，0.803和0.933。H-Y 分期中期[OR（95%CI): 4.725（1.742 ～ 12.814）]，H-Y 分期晚期[OR（95%CI): 5.083（1.919 ～ 13.464）]、UPDRS-Ⅲ评分[OR（95%CI): 3.257（1.464 ～ 7.246）]、NPASDP-4[OR（95%CI): 5.324（1.516 ～ 18.701）] 和MBP[OR（95%CI):5.769（2.459 ～ 13.533）] 是帕金森病患者CI 的影响因素（均P ＜ 0.05）；NPASDP-4[OR（95%CI): 4.768（2.382 ～ 9.543）]，MBP[OR（95%CI): 5.846（3.141 ～ 10.882）] 是帕金森病患者CI 严重程度的影响因素（均P ＜ 0.05）。结论 帕金森病患者血清NPASDP-4 和MBP 呈高水平，且均与CI 及其严重程度密切相关，可能具有一定的临床诊断价值。
Abstract:
Objective To explore the diagnostic value of serum neuronal Per-Arnt-Sim domain protein 4 (NPASDP-4) and myelin basic protein (MBP) expression in patients with Parkinson’s disease in relation to cognitive impairment (CI) and severity.Methods Selected and 138 Parkinson’s disease patients admitted to the 909th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China as the Parkinson’s disease group, and 69 healthy people in the physical examination center of the hospital were in the healthy control group. Patients with Parkinson’s disease were divided into normal cognitive function group (n=55), mild CI group (n=51) and dementia group (n=32) according to whether CI occurred and its severity. General data of subjects was collected, the serum levels of NPASDP-4 and MBP were detected by ELISA, correlation analysis was adopted by Spearman rank correlation or Pearson linear correlation, diagnostic value was analyzed by ROC curve, and influencing factors were analyzed by multivariate Logistic regression. Results Compared with the healthy control group, the levels of serum NPASDP-4 (6.75±0.48 ng/ml vs 2.38±0.31 ng/ml) and MBP (8.34±0.65 μg/L vs 3.54±0.42 μg/L) in the Parkinson’s disease group were increased with statistical significance (t=68.751, 55.761, all P<0.05). There were significant differences in H-Y stage among the normal cognitive function group, mild CI group and dementia group (χ2=7.788, P ＜ 0.05). Compared with the group with normal cognitive function (47.92±11.63 score), the mild CI group (50.78±13.69 score) and the dementia group (41.95±10.36 score) showed an increase in UPDRS-III scores, and the differences were statistically significant (H=6.672, all P<0.05). In normal cognitive function group, mild CI group and dementia group, the course of disease, and serum NPASDP-4 (5.89±0.40, 6.83±0.55,8.12±0.54 ng/ml） and MBP (6.65±0.56, 8.94±0.69,10.27±0.70μg/L） levels were significantly increased (H=207.950，355.594，all P<0.05), while MMSE score (28.47±0.94, 24.51±1.35,17.09±2.57 score）, MoCA score (27.45±1.03, 20.18±1.92,11.75±2.53 score） and GPCOG total score (13.47±0.69, 10.25±1.04, 8.97±0.82 score） were significantly decreased, and the differences were statistically significant (H=515.005, 775.933, 327.584，all P<0.05), respectively. The serum levels of NPASDP-4 and MBP in Parkinson’s disease patients were significantly positively correlated with the course of disease (r=0.316, 0.358）, H-Y stage (r=0.345, 0.384） and UPDRS- Ⅲ score (r=0.371, 0.396）, and significantly negatively correlated with MMSE score (r=-0.468, -0.517）, MoCA score (r=-0.504, -0.569） and GPCOG total score (r=-0.527, -0.538） (all P<0.05), respectivey. The areas under the curve (AUC) of the serum levels of NPASDP-4， MBP and their combination in diagnosing of Parkinson’s disease were 0.850，0.930 and 0.960，respectively. The AUC of the serum levels of NPASDP-4 and MBP and their combination in diagnosing the severity of CI in patients with Parkinson’s disease were 0.866，0.803 and 0.933, respectively. H-Y stage metaphase [OR(95%CI)：4.725(1.742 ～ 12.814)]，H-Y stage advanced [OR(95%CI) ：5.083(1.919 ～ 13.464)], UPDRS- Ⅲ score [OR(95%CI) ：3.257(1.464 ～ 7.246)], NPASDP-4[OR(95%CI) ： 5.324(1.516 ～ 18.701)] and MBP [OR(95%CI) ：5.769(2.459 ～ 13.533)] were the influential factors for CI in patients with Parkinson’s disease (all P<0.05). NPASDP-4[OR(95%CI) ：4.768(2.382 ～ 9.543)] and MBP[OR(95%CI) ： 5.846(3.141 ～ 10.882)] were the influential factors for the severity of CI in patients with Parkinson’s disease (all P<0.05). Conclusion The serum levels of NPASDP-4 and MBP in patients with Parkinson’s disease were high, and they were closely related to CI and its severity, which may have certain clinical diagnostic value.

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备注/Memo

备注/Memo:
基金项目：福建省自然科学基金项目（2018J01152）。
作者简介： 郑德泉（1972-），男，本科，副主任医师，研究方向：脑血管疾病、神经变性病、帕金森、癫痫等，E-mail：zdq778899z@163.com。
通讯作者：吴义森（1977-），男，本科，副主任医师，研究方向：常见慢病筛查、慢病管理，E-mail：qzzpt68@163.com。
更新日期/Last Update: 2024-05-15