血清S100β、NSE、BDNF水平与帕金森病合并认知功能障碍的相关性

Correlation between serum levels of S100β,NSE,and BDNF and cognitive impairments in patients with Parkinson disease

目的探讨血清S100β、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、脑源性神经营养因子(brainderived neurotrophic factor,BDNF)水平与帕金森病(Parkinson disease,PD)患者不同程度认知功能障碍的相关性。方法选择2021年4月至2023年3月上海市徐汇区中心医院收治的PD患者73例,根据Hoehn-Yahr分级标准分为轻度组(≤2级,n=31)、中度组(2.5~3级,n=29)和重度组(4~5级,n=13)。采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评定患者认知功能,并测定患者的血清S100β、NSE及BDNF水平,比较其与MoCA评分的相关性。结果不同H-Y分级患者的MoCA评分、S100β、NSE、BDNF水平差异均有统计学意义(均P<0.05)。Spearman秩和分析发现,血清S100β、NSE与MoCA评分均负相关(r=﹣0.563,P<0.001;r=﹣0.389,P=0.003),血清BDNF水平与MoCA评分正相关(r=0.454,P<0.001)。ROC曲线显示,血清S100β、NSE、BDNF水平诊断PD患者并发认知功能障碍的AUC分别为0.817(95%CI 0.718~0.915)、0.749(95%CI 0.636~0.862)、0.727(95%CI 0.611~0.843),三者联合诊断的AUC为0.904(95%CI 0.837~0.970)。结论PD患者的认知水平与病情相关,血清S100β、NSE、BDNF水平可辅助研判PD患者认知功能障碍程度,并为PD的病情严重程度提供临床参考。

Objective To explore the correlation between the levels of the serum S100β,neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF)and cognitive dysfunction in Parkinson disease(PD).Methods From April 2021 to March 2023,73 patients with PD admitted to Shanghai Xuhui Hospital were selected and divided into mild group(≤2,n=31),moderate group(2.5-3,n=29)and severe group(4-5,n=13)according to Hoehn Yahr grading standard.Montreal Cognitive Assessment(MoCA)was used to assess patients’cognitive function,the patient’s serum S100β,NSE and BDNF levels was measured,compare its correlation with MoCA scores.Results The MoCA score,S100β,NSE and BDNF levels of patients with different H-Y grades were statistically significant(all P<0.05).Spearman rank sum analysis found that serum S100β,NSE and MoCA scores were significantly negatively correlated(r=﹣0.563,P<0.001;r=﹣0.389,P=0.003).The serum BDNF level was positively correlated with MoCA score(r=0.454,P<0.001).ROC curve display,serum S100β,NSE,BDNF levels and cognitive dysfunction in PD patients have certain predictive value(all P<0.05).The area under the curve(AUC)is 0.817(95%CI 0.718-0.915),0.749(95%CI 0.636-0.862),0.727(95%CI 0.611-0.843)respectively.The AUC of the combined diagnosis was 0.904(95%CI 0.837-0.970).Conclusion The cognitive level of PD patients is related to their disease grade,and the serum levels of S100β,NSE and BDNF can provide clinical reference for the severity of PD and assist in diagnosing the degree of cognitive dysfunction of PD patients.