血清α-syn、Aβ1-42、SSA在帕金森病患者中的表达及与认知功能损害的关系

The Expression of Serum A-Syn, ABand SSA in Patients with Parkinson’s Disease and Their Relationship with Cognitive Impairment

目的:探讨血清α-突触核蛋白(α-synuclein,α-syn)、β淀粉样蛋白1-42(β-amyloid 1-42,Aβ1-42)、淀粉样蛋白A(serum amyloid A,SSA)在帕金森病患者中的表达及与认知功能损害的关系。方法:收集本院2018年7月2020年11月收治的136例帕金森病患者为病例组,依据Hoehn-Yahr(H-Y)分级分为早期组(n=76)与中晚期组(n=60);依据蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,Mo CA)分为认知功能正常组(n=94)与认知功能损害组(n=42)。另选同期本院体检正常者105例纳入对照组。对比各组血清α-syn、SSA、Aβ1-42水平及Mo CA,并用Pearson相关系数分析病例组患者血清α-syn、SSA、Aβ1-42水平与Mo CA的相关性,用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清α-syn、SSA、Aβ1-42水平对帕金森病和认知功能损害的诊断价值。结果:病例组血清α-syn、SSA水平高于对照组,差异有统计学意义(P<0.05);病例组Aβ1-42、Mo CA评分低于对照组(P<0.05)。病例组晚期患者血清α-syn、SSA水平高于早期患者(P<0.05);病例组晚期患者Aβ1-42、Mo CA评分低于早期患者,差异有统计学意义(P<0.05)。病例组有认知功能损害患者血清α-syn、SSA水平高于认知功能正常患者(P<0.05);病例组有认知功能损害患者Aβ1-42、Mo CA评分低于认知功能正常患者(P<0.05)。病例组患者血清α-syn、SSA与Mo CA均呈正相关(P<0.05),Aβ1-42与Mo CA呈正相关(P<0.05)。血清α-syn、SSA、Aβ1-42水平对帕金森病诊断的曲线下面积分别为0.858、0.821、0.785;血清α-syn、SSA、Aβ1-42水平对帕金森病认知功能损害预测的曲线下面积分别为0.877、0.825、0.783。结论:帕金森病患者血清α-syn、SSA、Aβ1-42水平较健康者变化明显,且可能和帕金森病的诊断、病情进展和认知功能损害有一定关系。

Objective:To investigate the expression of serumα-synuclein (α-syn),β-amyloid 1-42 (Aβ1-42) and serum amyloid A(SSA) in patients with Parkinson’s disease and their relationship with cognitive impairment.Methods:136 patients with Parkinson’s disease admitted in our hospital from July 2018 to November 2020 were collected as case group,and divided into early stage group(n=76) and middle and late stage group (n=60) according to Hoehn-Yahr (H-Y) grading.According to Montreal Cognitive Assessment Scale (Mo CA),the patients were divided into normal cognitive function group (n=94) and cognitive impairment group (n=42).Another105 cases with normal physical examination in the same period were included in the control group.The levels of serumα-syn,SSA,Aβ1-42and Mo CA in each group were compared.Pearson correlation coefficient was used to analyze the correlation between the levels of serumα-syn,SSA,Aβ1-42and Mo CA.The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of serumα-syn,SSA,Aβ1-42in Parkinson’s disease and cognitive impairment.Results:The levels of serumα-syn and SSA in case group were higher than those in control group,the difference was statistically significant (P<0.05).The Aβ1-42and Mo CA scores in the case group were lower than those in the control group (P<0.05).Serumα-syn and SSA levels in patients with advanced stage were higher than those in patients with early stage (P<0.05).The scores of Aβ1-42and Mo CA in late patients were lower than those in early patients,the difference was statistically significant (P<0.05).Serumα-syn and SSA levels in patients with cognitive impairment were higher than those in patients with normal cognitive function (P<0.05).The scores of Aβ1-42and Mo CA in patients with cognitive impairment were lower than those in patients with normal cognitive function (P<0.05).Serumα-syn,SSA were positively correlated with Mo CA (P<0.05),and Aβ1-42was positively correlated with Mo CA (P<0.05).The areas under the curve of serumα-syn,SSA and Aβ1-42levels for diagnosis of Parkinson’s disease were 0.858,0.821 and 0.785.The areas under the curve for predicting cognitive impairment of Parkinson’s disease by serumα-syn,SSA and Aβ1-42levels were 0.877,0.825 and 0.783.Conclusion:Serum levels ofα-syn,SSA and Aβ1-42in patients with Parkinson’s disease are significantly different from those in healthy people,which may be related to the diagnosis,progression and cognitive impairment of Parkinson’s disease.