帕金森患者血清apelin-13、CXCL12水平与认知功能障碍的相关性及其诊断价值

Correlation between serum apelin-13,CXCL12 levels and cognitive dysfunction in patients with Parkinson's disease and their diagnostic value

目的探究帕金森(PD)患者血清apelin-13、趋化因子12(CXCL12)水平与认知功能障碍的相关性及其诊断价值。方法选取2016年1月至2021年1月郑州中心医院神经内科收治的80例PD患者作为PD组,根据蒙特利尔认知评估量表(MoCA)评分将PD患者分为认知障碍组48例(<26分)与非认知障碍组32例(≥26分);根据PD患者的H-Y评级和统一PD评分量表(UDPRSⅢ)评分将其分为H-Y 1~2期35例,H-Y 3期25例,H-Y 4期20例。同期选择于我院体检的80例健康志愿者作为对照组。采用酶联免疫吸附测定(ELISA)法检测所有受检者的血清apelin-13、CXCL12水平;采用Pearson法分析PD患者血清中apelin-13与CXCL12表达水平的相关性;采用Spearman法分析血清中apelin-13、CXCL12表达水平与MoCA评分的相关性;采用受试者工作特征曲线(ROC)分析血清apelin-13、CXCL12水平对PD的诊断价值。结果PD组患者的血清apelin-13水平为(12.36±1.54)ng/mL,明显低于对照组的(14.65±1.63)ng/mL,CXCL12水平为(21.52±2.48)ng/mL,明显高于对照组的(17.08±2.45)ng/mL,差异均有统计学意义(P<0.05);随着H-Y分期的增加,apelin-13水平显著降低,CXCL12水平显著升高,差异均有统计学意义(P<0.05);认知障碍组患者的血清apelin-13水平为(11.76±1.55)ng/mL,明显低于非认知障碍组的(13.25±1.53)ng/mL,CXCL12水平为(22.46±2.45)ng/mL,明显高于非认知障碍组的(20.10±2.52)ng/mL,差异均有统计学意义(P<0.05);经Pearson法分析结果显示,PD患者血清中apelin-13与CXCL12表达水平呈负相关(r=-0.522,P<0.01);经Spearman法分析结果显示,血清中apelin-13表达水平与MoCA评分呈正相关(r=0.660,P<0.01),CXCL12表达水平与MoCA评分呈负相关(r=-0.482,P<0.01);经ROC分析结果显示,apelin-13、CXCL12两者联合检测诊断PD发生的AUC为0.943,明显高于apelin-13和CXCL12单独诊断的AUC值(分别为0.870、0.888)(Z=22.930、25.121,P<0.01)。结论PD患者血清中apelin-13呈低表达,CXCL12呈高表达,与患者认知功能障碍具有相关性,对PD具有临床诊断价值。

Objective To investigate the correlation between serum apelin-13,chemokine 12(CXCL12)levels and cognitive dysfunction in patients with Parkinson's disease(PD)and its diagnostic value.Methods Eighty patients with PD admitted to the Department of Neurology,Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2016 to January 2021 were selected as the PD group.According to the Montreal Cognitive Assessment Scale(MoCA)score,PD patients were divided into 48 patients with cognitive impairment(<26 points)and 32 patients with non-cognitive impairment(≥26 points).According to H-Y rating and UDPRSⅢscore,PD patients were divided into 35 cases of H-Y stage 1-2,25 cases of H-Y stage 3,and 20 cases of H-Y stage 4.During the same period,80 healthy volunteers who underwent physical examination in the hospital were selected as the control group.Serum apelin-13 and CXCL12 levels were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between apelin-13 and CXCL12 expression levels in serum of PD patients was analyzed by Pearson method.The correlation between the expression levels of apelin-13 and CXCL12 in serum and MoCA score was analyzed by Spearman method.The diagnostic value of serum apelin-13 and CXCL12 levels in PD was analyzed by receiver operating characteristic(ROC).Results The serum apelin-13 level in PD group was(12.36±1.54)ng/mL,which was significantly lower than(14.65±1.63)ng/mL in the control group;CXCL12 level was(21.52±2.48)ng/mL,which was significantly higher than(17.08±2.45)ng/mL in the control group;the differences were statistically significant(P<0.05).With the increase of H-Y stage,the level of apelin-13 was significantly decreased and the level of CXCL12 was significantly increased(P<0.05).The serum apelin-13 level in the cognitive impairment group was(11.76±1.55)ng/mL,which was significantly lower than(13.25±1.53)ng/mL in the non-cognitive impairment group,and CXCL12 level was(22.46±2.45)ng/mL,significantly higher than(20.10±2.52)ng/mL in the non-cognitive impairment group,with statistically significant differences(P<0.05).The results of Pearson analysis showed that the expression level of apelin-13 in serum of PD patients was negatively correlated with CXCL12(r=-0.522,P<0.01).Spearman analysis showed that the expression level of apelin-13 was positively correlated with MoCA score(r=0.660,P<0.01),and the expression level of CXCL12 was negatively correlated with MoCA score(r=-0.482,P<0.01).The results of ROC analysis showed that the AUC of apelin-13 and CXCL12 combined detection for PD occurrence was 0.943,which was significantly higher than 0.870 of apelin-13 alone and 0.888 of CXCL12 alone(Z=22.930,25.121,P<0.01).Conclusion The expression of apelin-13 in the serum of PD patients is low,while the expression of CXCL12 is high.They are both associated with cognitive dysfunction of patients and have clinical diagnostic value for PD.