外周血淋巴细胞亚群失调与帕金森病相关性分析及临床意义

Correlation between peripheral blood lymphocyte subsets imbalance and Parkinson's disease and its clinical significance

目的探讨外周血淋巴细胞亚群失调与帕金森病(PD)的相关性及临床意义。方法以2021年3月10日-2022年2月10日于兰州大学第一医院神经内科住院的43例PD患者为PD组,纳入同期住院的20例性别、年龄、既往病史相似的非神经变性病患者为对照组。利用流式细胞术检测PD患者外周血淋巴细胞各亚群比例,比较PD组与对照组的差异性;分析PD组症状学评分与外周血淋巴细胞各亚群占比之间的相关性;评估外周血淋巴细胞亚群失调能否为PD的诊断提供依据。结果与对照组相比,PD组患者外周淋巴细胞亚群中CD19^(+)B细胞和CD4^(+)CD25^(+)Treg细胞占比下降,CD16^(+)CD56^(+)NK细胞占比增加,差异具有统计学意义(P<0.05)。CD4^(+)CD25^(+)Treg细胞占比与焦虑自评量表和抑郁自评量表评分具有相关性(P<0.05)。CD16^(+)CD56^(+)NK细胞受试者操作特征曲线下面积为0.660,95%CI:[0.510,0.810],P=0.043,Youden’s指数为0.44,诊断阈值为12.15,敏感度为69.00%,特异度为75.00%。结论PD患者存在外周血淋巴细胞亚群失调,且各亚群变化不一致,推测外周血淋巴细胞亚群可能参与神经炎症介导的多巴胺能神经元损伤;CD16^(+)CD56^(+)NK细胞有可能成为PD诊断的生物标志物。

Objective To investigate the correlation between peripheral blood lymphocyte subsets imbalance and Parkinson's disease(PD)and its clinical significance.Methods 43 patients with PD who were hospitalized in the Department of Neurology of The First Hospital of Lanzhou University from March 10,2021 to February 10,2022 were selected as the PD group,and 20 patients with non-neurodegenerative disease hospitalized during the same period with similar gender,age and previous medical history were included as the control group.The percentages of lymphocyte subsets in peripheral blood were detected by flow cytometry,and the differences between the PD group and the control group compared.The correlation between the symptom scores of the PD group and the lymphocyte subsets in peripheral blood was analyzed.The disorder of peripheral blood lymphocyte subsets was evaluated for PD.Results Compared with the control group,the percentages of CD19^(+)B cells and CD4^(+)CD25^(+)Treg cells in peripheral lymphocyte subsets of PD patients decreased,and the percentages of CD16^(+)CD56^(+)NK cells increased,the difference being statistically significant(P<0.05).CD4^(+)CD25^(+)Treg cell percentages was correlated with the self-rating anxiety scale and self-rating depression scale(P<0.05).The area under the curve of CD16^(+)CD56^(+)NK cells was 0.660,95%CI:[0.510,0.810],P=0.043,Youden's index 0.44,diagnostic threshold 12.15,sensitivity 69.00% and specificity 75.00%.Conclusion There is peripheral blood lymphocyte subsets imbalance in PD patients.It is speculated that peripheral blood lymphocyte subsets may be involved in dopamicnergic neuron injury mediated by neruoinflammation,and the changes of each subpopulation are not consistent,and CD16^(+)CD56^(+)NK cells may be biomarkers for PD diagnosis.