血清表皮生长因子对帕金森病认知功能损害的预测价值  

Value of serum levels of epidermal growth factor on predicting mild cognitive decline in Parkinson disease

作　　者：李振光[1] 于成勇[2] 于占彩[1] 马端兰 张金彪[1] 王鹏飞[1] 

机构地区：[1]威海市立医院,264200 [2]威海市文登中心医院,264400

出　　处：《中国神经免疫学和神经病学杂志》2015年第4期229-232,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：山东省医药卫生科技发展计划资助项目(No.2007HW020)

摘　　要：目的研究帕金森病（PD）患者血清表皮生长因子（EGF）水平变化,探讨EGF与PD相关性认知功能障碍之间的关系。方法 158例未经药物治疗的早期PD患者纳入研究,以国际帕金森病运动障碍协会改良统一帕金森病评价量表（MDS-UPDRS）评估患者运动障碍,以Hoehn＆Yahr分级与评估疾病严重程度（以1~2级定义为PD早期）,以蒙特利尔认知评估量表（MoCA）中文版进行全面认知功能状况评定,根据认知功能水平将患者分为轻度认知功能障碍组（PD-MCI组）和无认知功能障碍组（PD-NCI组）,分别于入组及24个月随访结束时进行上述评估。应用双抗体夹心法（ABC-ELISA）测定血清EGF水平,PD-NCI组根据血清EGF水平进行四分位分组,第一四分位包括EGF水平最低的四分之一患者,于随访24个月后比较4个四分位组MCI转化率。结果 158例PD患者中71例（44.9%）存在PD-MCI,87例（55.1%）为PD-NCI。PD-MCI组MoCA评分（20.03±3.22）显著低于PD-NCI组（28.11±1.78;t=-5.51,P=0.003）。PD-MCI组血清EGF水平〔（269.8±77.7）pg/mL〕低于PD-NCI组〔（489.5±65.6）pg/mL〕（t=-5.29,P=0.004）;87例PD-NCI中,EGF水平第四四分位患者（9.5%;χ2=5.69,P〈0.05）及第二、三四分位患者（均为13.6%,χ2=4.76,P〈0.05）MCI转化率均低于EGF水平最低的四分位患者（59.1%）。结论血清EGF水平降低可能增加PD患者认知功能障碍的风险。EGF有可能成为预测PD-MCI的一种新的血液学生物标记物。Objective To observe changes of serum epidermal growth factor（EGF）levels in a cohort of patients with newly diagnosed Parkinson disease（PD）,and explore correlation of EGF serological levels with cognitive dysfunction.Methods A total of 158 patients with early PD participated in this study.Assessments included measures of motor disability（Movement Disorders Society-revised Unified Parkinson＇s Disease Rating Scale,MDS-UPDRS）Ⅲ,disease severity（Hoehn Yahr staging）,and global cognitive function（Montreal Cognitive Assessment,MoCA）.The patients with early PD in present study were divided into the mild cognitive impairment（PD-MCI）group and the no cognitive impairment（PD-NCI）group according to global cognitive level,and PD-NCI subjects were quartile grouping according to EGF levels.The assessments were adopted at the beginning and 24 months later.The ABC-ELISA assay was used to measure serum EGF levels in the cohort.The top quartile group included patients with the lowest quarter level of EGF.The MCI conversion rates were compared after 24 months of follow-up.Results Seventy-one patients（44.9%）were dignosed as PD-MCI,and87patients（55.1%）presented PD-NCI,there was a significant difference of the MoCA scales between the PDMCI group（20.03±3.22）and the PD-NCI group（28.11±1.78,t=-5.51,P=0.003）.The EGF levels in the PD-NCI group [（489.5±65.6）pg/mL]were significantly higher than in the PD-MCI group [（269.8±77.7）pg/mL,t=-5.29,P=0.004].Specifically,PD-NCI subjects with EGF levels in the lowest quartile（Quartile 1,59.1%）were six times more likely to convert to PD-MCI,with a median conversion time of 24 months.The MCI conversion rate of Quartile 1was higher than those of Quartile 2,Quartile 3（13.6%,χ2=4.76,P0.05）and Quartile 4（9.5%,χ2=5.69,P0.05）Conclusions Lower serum EGF levels in PD were associated with higher risk to development into cognitive dysfunction,and EGF may be a new serological biomarker for PD-MCI.

关 键 词：帕金森病 轻度认知障碍 表皮生长因子 生物标记物 

分 类 号：R741.04[医药卫生—神经病学与精神病学]