血浆神经轴突导向因子1表达水平与帕金森病的相关性研究

Relationship between plasma netrin-1 expression level and Parkinson disease

目的探讨血浆神经轴突导向因子1(Netrin-1)表达水平与帕金森病(PD)的相关性。方法选取无锡市第二人民医院PD门诊就诊的45例患者为PD组,并以同期年龄、性别和受教育水平与PD患者匹配的健康体检者29例为对照组,ELISA法检测血浆Netrin-1水平,采用Hoehn-Yahr(H-Y)分级量表,统一PD评定量表(UPDRS),PD非运动症状评价量表(NMSS),嗅觉减退量表(HRS),PD睡眠量表(PDSS),快速眼动睡眠期行为紊乱筛查量表(RRBDSQ),汉密尔顿抑郁量表(HAMD),简易智能状态检查量表(MMSE),蒙特利尔认知评估量表(MoCA),自主神经症状评定量表(SCOPA-AUT)评估PD患者症状。采用ROC曲线分析Netrin-1诊断PD的价值。结果 PD组Netrin-1水平明显低于对照组[127.7(77.7~183.2)ng/L vs 316.0(131.3~837.1)ng/L,P=0.010]。ROC曲线分析显示,血浆Netrin-1诊断PD的曲线下面积为0.723(95%CI:0.607~0.843,P=0.001)。PD患者血浆Netrin-1水平与H-Y分级、NMSS评分、HRS评分、RBDSQ评分和SCOPA-AUT评分无明显相关性(P>0.05),与UPDRS-Ⅰ评分、UPDRS-Ⅱ评分、UPDRS-Ⅲ评分、HAMD评分呈显著正相关,与PDSS评分、MMSE评分和MoCA评分呈显著负相关(P<0.05)。结论 PD患者血浆Netrin-1表达水平显著降低,可以作为诊断PD的实验室参考指标之一。但在PD患者中,其表达水平与PD运动症状严重程度呈正相关,可能是机体的一种代偿机制,可提示疾病的进展情况。

Objective To study the relationship between plasma netrin-1 expression level and Parkinson disease(PD).Methods Forty-five PD patients who visited the Outpatient Department in our hospital served as a PD group and 29 age-,gender-,and education level-matched healthy persons served as a control group in this study.The plasma netrin-1 expression level was measured by ELISA.The symptoms of PD patients were assessed according to their H-Y scale score, unified Parkinson’s disease rating scale(UPDRS) score, non-motor symptoms scale(NMSS) score, HRS score, PDSS score, RRBDSQ scale score, HAMD scale score, MMSE scale score, MoCA scale score, and SCOPA-AUT scale score.The value of plasma netrin-1 expression level for diagnosing PD was analyzed by ROC curve analysis.Results The plasma netrin-1 expression level was significantly lower in PD group than in control group [127.7(77.7-183.2)ng/L vs 316.0(131.3-837.1)ng/L,P=0.010].ROC curve analysis showed tha the AUC of plasma netrin-1 expression level for diagnosing PD was 0.723(95%CI:0.607-0.843,P=0.001).The plasma netrin-1 expression level was positively related with the UPDRS-Ⅰ score, UPDRS-Ⅱ score, UPDRS-Ⅲ score, HAMD scale score, and negatively related with the PDSS score, MMSE scale score, and MoCA scale score in PD patients.Conclusion The significantly reduced plasma netrin-1 expression level can be used as one of the laboratory testing parameters for diagnosing PD.Plasma netrin-1 expression level is positively related with the severity of PD motor symptoms, which may be a compensatory mechanism of the body and indicate the progression of PD.