帕金森病非痴呆与帕金森病痴呆患者血浆α-突触核蛋白、tau蛋白水平比较及临床意义

Comparison of plasma □-synuclein and tau protein in Parkinson's disease with dementia and Parkinson's disease without dementia

目的探讨帕金森病(Parkinson's disease, PD)非痴呆与帕金森病痴呆(PDdementia, PDD)患者血浆α-突触核蛋白(α-Synuclein)、tau蛋白表达水平及其与患者认知障碍的相关性。方法选择本院2016年1月至2017年12月收治并确诊为PD非痴呆患者和PDD患者分为PD非痴呆组与PDD组,每组各30例,选取同期健康体检者20例为对照组,采用人α-突触核蛋白、tau蛋白的酶联免疫吸附测定(enzyme-linked immunosorbent assay, ELISA)试剂盒检测3组血浆α-突触核蛋白、tau蛋白表达水平。简易精神状态检查(mini-mental state examination, MMSE)评估3组认知功能。采用Pearson相关分析分别探讨血浆α-突触核蛋白、tau蛋白水平与年龄、MMSE总分的相关性。结果 PD非痴呆组与对照组在MMSE总分方面差异无统计学意义(P>0.05),PD非痴呆组与PDD组的MMSE总分差异有统计学意义(P<0.05)。对照组血浆α-突触核蛋白、tau蛋白水平最低,PDD组血浆α-突触核蛋白水平(2.03±0.51)pg/ml显著高于PD非痴呆组(0.97±0.25)pg/ml,差异有统计学意义(P<0.05);PDD组血浆tau蛋白水平(93.54±16.72)ng/L略高于PD非痴呆组(89.91±10.03)ng/L,但两者差异无显著统计学意义(P=0.319)。相关分析显示,血浆α-突触核蛋白、tau蛋白水平与年龄无显著相关性(分别是r=0.054,P=0.631;r=0.028,P=0.806)。血浆α-突触核蛋白水平与MMSE总分存在着负相关(r=-0.739,P<0.001),未发现血浆tau蛋白水平与MMSE总分存在显著相关(r=-0.214,P=0.056)。结论 PD患者血浆α-突触核蛋白水平升高可能作为PD进展为PDD的预测因子。

Objective To detect the ɑ-synuclein,tau protein in peripheral blood from the cases of Parkinson’s disease(PD)with dementia and PD without dementia as well as its clinical significance.Methods Sixty PD patients including 30 cases of PD with dementia and 30 cases of PD without dementia as well as 20 healthy volunteers were selected as the subjects.The plasma level ofɑ-synuclein,tau protein was detected using enzymelinked immune-sorbent assay(ELISA)kits.Mini-mental state examination(MMSE)was used to assess the cognitive function of all cases.Pearson correlation analysis was used to investigate the correlation between plasma levels ofɑ-synuclein,tau protein and the age,MMSE,respectively.Results There was no significant difference in the total score of MMSE between the PD without dementia group and the healthy control group(P>0.05),and there were also significant differences in the total score of MMSE between PD with dementia group and PD without group(P<0.05).In the healthy control group,plasma levels ofɑ-synuclein and tau protein were the lowest.There were significant differences in plasma ɑ-synuclein between PD with dementia group and PD without group[(2.03±0.51)pg/ml v.s.(0.97±0.25)pg/ml)(P<0.05)].Plasma level of tau protein in PD with dementia group(93.54.±16.72)ng/L was slightly higher than that in the PD without dementia group(89.91±10.03)ng/L,but the difference was not statistically significant(P=0.319).Correlation analysis showed that there was no significant correlation between plasma levels of a-synaptic as well as tau protein and age,respectively(r=0.054,P=0.631;r=0.028,P=0.806).In addition,there was a negative correlation between plasma ɑ-synaptic nucleoprotein level and MMSE total score(r=-0.739,P<0.001).No significant correlation was found between plasma tau level and MMSE total score(r=-0.214,P=0.056).Conclusion Increased plasma level of ɑ-synaptic nucleoprotein in PD patients may be a predictor of PD progressing to PD with dementia.