帕金森病患者血清RANTES,MIP-1α表达水平变化与炎症因子水平的相关性及对认知功能障碍的预测价值

Correlation between changes in serum RANTES and MIP-1αexpression levels and inflammatory factor levels in patients with Parkinson's disease and their predictive value for cognitive dysfunction

目的探究帕金森病(Parkinson's disease,PD)患者血清活化T细胞趋化因子(Regulated upon activation normal T cell expressed and secreted,RANTES)、巨噬细胞炎性蛋白-1α(Macrophage inflammatory protein1α,MIP-1α)表达水平变化与炎症因子水平的相关性,并分析血清RANTES,MIP-1α表达水平变化对PD患者认知功能障碍的预测价值。方法选取2021年3月-2023年3月本院收治的100例PD患者,纳入PD组;同期选取体检健康者40例,纳入对照组;2组均进行RANTES,MIP-1α水平及炎症因子[白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平检测,Pearson法分析PD患者RANTES,MIP-1α水平与炎症因子水平的相关性;根据患者有无认知功能障碍(Cognition impairment,CI)分为发生组及未发生组,统计2组患者RANTES,MIP-1α水平;收集2组患者临床资料,采用多因素Logistic回归分析法明确影响PD-CI发生的危险因素,并采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析RANTES,MIP-1α水平对PD的预测价值。结果PD组RANTES,MIP-1α,IL-1β,IL-6及TNF-α水平均高于对照组(P<0.05);Pearson相关性分析显示,RANTES,MIP-1α水平与IL-1β,IL-6,TNF-α水平均呈正相关(r>0.491,P<0.05);100例PD患者中34例(34%)发生CI;发生组患者发病年龄、病程、受教育年限、混合型占比及血清RANTES,MIP-1α水平均高于未发生组(P<0.05);多因素Logistic回归分析显示,病程长、统一帕金森病评定量表(Unified Parkinson's disease rating scale,UPDRSⅡ)评分高及RANTES,MIP-1α高水平是影响PD-CI发生的的独立危险因素(P<0.05);ROC曲线分析显示RANTES,MIP-1α水平单独及联合预测PD患者发生认知功能障碍的曲线下面积(Area under the curve,AUC)(95%CI)分别为0.743(0.646~0.825)、0.716(0.617~0.801)、0.885(0.805~0.940),二者水平联合检查对PD-CI发生的预测效能高于各项单独水平检测(Z=1.972、2.4044,P<0.05)。结论血清RANTES,MIP-1α表达水平与IL-1β、IL-6及TNF-α水平均呈正相关,其中RANTES,MIP-1α高水平是影响PD-CI发生的危险因素,二者水平联合检测对PD-CI具有较高的预测价值。

Objective To investigate the correlation between changes in the expression levels of serum regulated upon activation normal T cell expressed and secreted(RANTES),macrophage inflammatory protein1α(MIP-1α)and inflammatory factors in Parkinson's disease(PD)patients,and to analyze the predictive value of serum RANTES and MIP-1αexpression for cognitive dysfunction in patients with PD.Methods 100 patients with PD admitted to our hospital from March 2021 to March 2023 were included in the PD group,and 40 healthy subjects were included in the control group during the same period.RANTES,MIP-1αand inflammatory factor levels[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]were measured in both groups.The correlation between the levels of RANTES,MIP-1αand inflammatory factors in PD patients was analyzed by Pearson method.Patients were divided into occurrence group and non-occurrence group according to whether they had cognitive dysfunction(CI),and the levels of RANTES and MIP-1αwere measured in the two groups.Clinical data of the patients in the two groups were collected,and multi-factor Logistic regression analysis was used to identify the risk factors affecting PD-CI.The predictive value of RANTES and MIP-1αfor PD was analyzed by receiver operating characteristic(ROC)curve.Results The levels of RANTES,MIP-1α,IL-1β,IL-6 and TNF-αin PD group were higher than those in control group(P<0.05).Pearson correlation analysis showed that the levels of RANTES and MIP-1αwere positively correlated with the levels of IL-1β,IL-6 and TNF-α(P<0.05).Among 100 PD patients,34(34%)had CI.The age of onset,course of disease,years of education,proportion of mixed type and levels of serum RANTES and MIP-1αin the occurrence group were higher than those in the non-occurrence group(P<0.05).Multivariate Logistic regression analysis showed that long course of disease,high unified Parkinson's disease rating scale(UPDRSⅡ)score and high level of RANTES and MIP-1αwere independent risk factors for the occurrence of PD-CI(P<0.05).ROC analysis showed that the area under the curve(AUC)value(95%CI)of RANTES and MIP-1αalone and combined to predict the occurrence of cognitive dysfunction in PD patients were 0.743(0.646~0.825),0.716(0.617~0.801)and 0.885(0.805~0.940)respectively.The prediction efficiency of PD-CI was higher than that of each single test(Z=1.972,2.4044,P<0.05).Conclusion The expression of RANTES and MIP-1αin serum was positively correlated with IL-1β,IL-6 and TNF-α,and the high level of RANTES and MIP-1αwas a risk factor for the occurrence of PD-CI,and the combined detection of RANTES and MIP-1αhad a high predictive value for PD-CI.