中老年帕金森病患者血清胶质纤维酸性蛋白浓度变化的临床意义

Clinical significance of serum glial fibrillary acidic protein level in middle-aged and elderly patients with Parkinson's disease

目的探讨中老年帕金森病患者血清胶质纤维酸性蛋白(GFAP)浓度变化的临床意义.方法前瞻性研究,收集2017年1月至2021年7月在浙江大学医学院附属浙江医院神经内科住院治疗的帕金森病(帕金森病组)患者39例和健康受试者(对照组)17例,利用Simoa超敏蛋白质检测技术检测帕金森病组和对照组血清GFAP含量,并分析血清GFAP含量与帕金森病患者年龄、性别、临床表现分型、抑郁评分、蒙特利尔认知评估量表(MoCA)评分及简易智力状态检查量表(MMSE)评分的相关性.结果帕金森病组患者血清GFAP含量(219.6±166.2)ng/L较对照组(109.9±56.6)ng/L增加(P<0.01).帕金森病组患者血清GFAP含量与年龄、性别、抑郁及MoCA评分无相关性(年龄:r=0.042;性别:r=-0.142;抑郁:r=0.076;MoCA评分:r=0.014;均P>0.05),但与MMSE评分呈负相关(r=-0.433,P<0.05).结论帕金森病患者血清GFAP水平与MMSE评分呈负相关,提示血清GFAP含量增加可能对帕金森病患者认知功能下降具有一定提示意义,在临床工作中应予以关注.

Objective To investigate the clinical significa nee of serum glial fibrillary acidic protein(GFAP)level in middle-aged and elderly patients with Parkinson's disease(PD).Methods In the prospective study.a total of 39 patie nls with PD hospitalized in the Department of Neurology of Zhejiang Hospital affiliated to Zhejiang University School of Medicine,and 17 healthy subjects from January 2017 to May 2021 were collected.Serum GFAP levels in the PD group and healthy control(CT)group were detected by an ultra-sensitive Simoa hypersensilive protein detection technology.The correlations of serum GFAP level with age,gender«clinical presentation lype,depression score.Montreal Cognitive Assessment Scale(M()CA)score and Mini-Mental State Examination(MMSE)score were analyzed.Results The level of serum GFAP was significantly higher in PD group(219.6±166.2)ng/L than in CT group(109.9±56.6)ng 1.(P <0.01).In PD group,lhere was no correlati on of serum GFAP with age.gender.clinical classification,depressi on and M()CA score(age:r=0.042.gender:r=-0.142.depression score:r=0.076,MoCA score:r=0.014,all P>0.05);but there was a significant negative correlation between serum GFAP and MMSE score(r=-0.433,P< 0.05).Conclusions There is a negative correlation between serum GFAP level and MMSE score・suggesting that the increase of serum GFAP might be suggestive of cognitive decline in Parkinson's disease patients to some extent,which should be paid attention to in clinical work.