老年帕金森病患者血清Aβ1-42、EGF和Hcy水平与认知功能障碍及疾病严重程度的关系及其预测价值分析

Correlation of Serum Aβ1-42, EGF and Hcy Levels with Cognitive Dysfunction and Disease Severity in Elderly Patients with Parkinson’s Disease and Their Predictive Value

目的:探讨老年帕金森病(PD)患者血清中β淀粉样蛋白1-42(Aβ1-42)、表皮生长因子(EGF)和同型半胱氨酸(Hcy)的表达水平,分析其与认知功能障碍及疾病严重程度的关系,并探讨其对老年PD患者认知功能障碍的预测价值。方法:将2018年10月~2021年10月在河北北方学院附属第一医院进行治疗的老年PD患者120例研究对象纳入PD组,另选取同期在河北北方学院附属第一医院进行健康体检的120例老年健康体检者为对照组。检测PD组、对照组血清Aβ1-42、EGF、Hcy水平,比较各血清指标水平的差异。Spearman相关性分析法分析血清中Aβ1-42、EGF、Hcy与简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(Mo CA)评分的相关性。接收者工作特征曲线(ROC)分析血清Aβ1-42、EGF、Hcy水平对老年PD患者认知功能障碍的预测价值。结果:PD组患者血清Aβ1-42、EGF水平低于对照组,Hcy水平高于对照组,差异有统计学意义(P<0.05)。随着PD分期的加重,老年PD患者的Aβ1-42、EGF水平随之降低,Hcy水平则随之升高(P<0.05)。PD伴认知功能障碍组的Aβ1-42、EGF水平和MMSE、Mo CA评分低于PD认知功能正常组,Hcy则高于PD认知功能正常组,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,Aβ1-42、EGF水平与MMSE、MoCA评分均呈正相关性(P<0.05),Hcy水平与MMSE、MoCA评分均呈负相关性(P<0.05)。血清Aβ1-42、EGF、Hcy单独应用时对老年PD患者认知功能障碍均有一定的预测效能,而血清Aβ1-42、EGF、Hcy联合应用的曲线下面积(AUC)(0.95CI)为0.841(0.738~0.932),预测效能高于单一指标检测。结论:老年PD患者血清Aβ1-42、EGF水平呈低表达,Hcy水平呈高表达,血清Aβ1-42、EGF、Hcy水平参与了老年PD患者病情的发生、进展过程,且与患者认知功能关联密切。血清Aβ1-42、EGF、Hcy水平联合检测在预测老年PD患者的认知功能障碍方面具有一定的临床价值。

Objective: To investigate the expression levels of β-amyloid 1-42(Aβ1-42), epidermal growth factor(EGF) and homocysteine(Hcy) in serum of elderly Parkinson’s disease(PD) patients, and to analyze their relationship with cognitive dysfunction and disease severity, and to explore its predictive value for cognitive impairment in elderly PD patients. Methods: A total of 120 elderly PD patients who were treated in The First Affiliated Hospital of Hebei North University from October 2018 to October 2021 were included in the PD group, and 120 elderly healthy subjects who underwent physical examination in The First Affiliated Hospital of Hebei North University during the same period were selected as the control group. The serum levels of Aβ1-42, EGF and Hcy were detected in the PD group and the control group, and the differences in the levels of each serum index were compared. Spearman correlation analysis was used to analyze the correlation of serum Aβ1-42, EGF, Hcy with Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) scores. Receiver operating characteristic curve(ROC) was used to analyze the predictive value of serum Aβ1-42,EGF and Hcy levels on cognitive impairment in elderly PD patients. Results: Serum Aβ1-42 and EGF levels in PD group were lower than those in control group, and Hcy level was higher than that in control group,the difference was statistically significant(P<0.05). With the aggravation of PD stage, the levels of Aβ1-42 and EGF in elderly PD patients decreased, while the level of Hcy increased(P<0.05). The levels of Aβ1-42, EGF, MMSE and MoCA in the PD with cognitive impairment group were lower than those in the PD cognitive function normal group, and the Hcy was higher than PD cognitive function normal group, and the differences were statistically significant(P<0.05). Spearman correlation analysis showed that Aβ1-42 and EGF levels were positively correlated with MMSE and MoCA scores(P<0.05), and Hcy levels were negatively correlated with MMSE and MoCA scores(P<0.05). Serum Aβ1-42, EGF and Hcy alone had certain predic tive efficacy for cognitive impairment in elderly PD patients, while the area under the curve(AUC)(0.95CI) of serum Aβ1-42, EGF and Hcy combined application was 0.841(0.738~0.932), the prediction performance was higher than that of single index detection. Conclusion: Serum Aβ1-42 and EGF levels in elderly PD patients are lowly expressed, while Hcy levels are highly expressed.Serum Aβ1-42, EGF and Hcy levels are involved in the occurrence and progression of the disease in elderly PD patients, and are associated with cognitive function of patients close. The combined detection of serum Aβ1-42, EGF and Hcy levels has certain clinical value in predicting cognitive dysfunction in elderly PD patients.