脑白质病变的严重程度与帕金森病患者脑源性神经营养因子和肿瘤坏死因子α的关系  

Relationship of severity of white matter lesions with BDNF and TNF-αin patients with Parkinson's disease

作　　者：黄广苏[1] 覃彬 陆菲[1] 刘海静 陈红[1] 韦璐[1] 邓奎品[1] Huang Guangsu;Qin Bin;Lu Fei;Liu Haijing;Chen Hong;Wei Lu;Deng Kuiping(Department of Neurology,Liuzhou People's Hospital,Liuzhou 545006,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]柳州市人民医院神经内科,545006

出　　处：《中华老年心脑血管病杂志》2022年第11期1173-1177,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广西壮族自治区卫生健康委员会科研项目(Z20210344)。

摘　　要：目的探讨脑白质病变(WML)的严重程度与帕金森病(PD)患者血清脑源性神经营养因子(BDNF)、TNF-α表达的关系。方法前瞻性纳入2018年3月至2020年3月柳州市人民医院收治的253例PD患者作为观察组,选取同期健康体检者200例作为对照组,收集2组患者的病史及人口学资料,测定其血清TNF-α、α突触核蛋白及BDNF水平。根据Fazekas分级将观察组分为4组,正常组54例、轻度异常组94例、中度异常组61例和重度异常组44例。比较4组患者血清BDNF、TNF-α表达差异及WML的严重程度,应用logistic回归分析及Spearman相关分析PD患者并发WML的影响因素。结果观察组血清TNF-α、α突触核蛋白水平显著高于对照组,血清BDNF水平显著低于对照组(P<0.01);观察组WML发生率明显高于对照组(78.66%vs 51.00%,P<0.05)。与正常组比较,轻度异常组、中度异常组及重度异常组患者年龄、病程、Hoehn-Yahr分级、统一帕金森病评定量表(UPDRS)-Ⅲ评分、TNF-α及α突触核蛋白水平显著升高(P<0.05),血清BDNF水平显著降低(P<0.05)。Spearman相关性分析显示,年龄、病程、Hoehn-Yahr分级、UPDRS-Ⅲ评分及血清TNF-α、α突触核蛋白水平均与WML的严重程度呈正相关(P<0.01);血清BDNF水平与WML严重程度呈负相关(P<0.01)。多因素logistic回归分析显示,血清TNF-α(OR=1.288,95%CI:1.184~1.401,P=0.000)、α突触核蛋白(OR=3.714,95%CI:1.206~11.439,P=0.022)水平是影响观察组患者发生WML的危险因素,血清BDNF(OR=0.849,95%CI:0.827~0.871,P=0.000)是保护因素。结论血清TNF-α、α突触核蛋白水平升高可能是影响PD患者并发WML的独立危险因素,血清BDNF水平升高是PD患者并发WML的保护因素。Objective To investigate the relationship of the severity of white matter lesions(WML)with serum levels of brain-derived neurotrophic factor(BDNF)and tumor necrosis factor-α(TNF-α)in patients with Parkinson's disease(PD).Methods A total of 253 PD patients admitted to our hospital from March 2018 to March 2020 were prospectively recruited and assigned into the observation group,and 200 healthy subjects who taking physical examination during the same period were selected as the control group.The medical history and demographic data of these participants were collected,and the serum levels of TNF-α,α-synuclein and BDNF were measured.According to Fazekas scale,the observation groups were divided into 4 subgroups,including normal subgroup(n=54),mild abnormal subgroup(n=94),moderate abnormal subgroup(n=61)and severe abnormal subgroup(n=44).The serum levels of BDNF and TNF-αand the severity of WML were compared among the 4 subgroups.Logistic regression analysis and Spearman correlation analysis were applied to analyze the influencing factors for PD patients com-plicated with WML.Results Serum TNF-αandα-synuclein levels were significantly higher,while that of BDNF was obviously lower in the observation group than the control group(P<0.01).The incidence of WML was 78.66%in the observation group,statistically higher than that in the control group(51.00%,P<0.05).The patients from the mild,moderate and severe abnormal subgroups had older age,longer course of disease,elevated Hoehn-Yahr grade,higher UPDRS-Ⅲscore,and increased TNF-αandα-synuclein levels(P<0.05),and decreased serum BDNF level(P<0.05)when compared with those of the normal group.Spearman correlation analysis indicated that age,course of disease,Hoehn-Yahr grade,UPDRS-Ⅲscore,and serum TNF-αandα-synuclein levels were positively(P<0.01),and serum BDNF level was negatively correlated with the severity of WML(P<0.01).Serum TNF-α(OR=1.288,95%CI:1.184-1.401,P=0.000)andα-synuclein(OR=3.714,95%CI:1.206-11.439,P=0.022)levels were risk factors,while serum B

关 键 词：脑白质病 帕金森病 脑源性神经营养因子 肿瘤坏死因子Α 白细胞介素6 Α突触核蛋白 

分 类 号：R742.5[医药卫生—神经病学与精神病学]