肌萎缩侧索硬化患者血清鸢尾素、热休克蛋白70检测及其临床意义  

Detection of Serum Irisin and HSP70 in Patients with Amyotrophic Lateral Sclerosis and its Clinical Significance

作　　者：吴佳羽[1] 钟曌 陈阳[1] 万琦 孙世辉 任佳封 张丽萍 WU Jia-yu;ZHONG Zhao;CHEN Yang;WAN Qi;SUN Shi-hui;REN Jia-feng;ZHANG Li-ping(Department of Neurology,The 904 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Wuxi,Jiangsu,214000,China;Department of Internal Medicine-Neurology,The Second Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi,710032,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院神经内科,江苏无锡214000 [2]空军军医大学第二附属医院神经内科,陕西西安710032

出　　处：《现代生物医学进展》2022年第23期4501-4505,4434,共6页Progress in Modern Biomedicine

基　　金：陕西省科技计划重点产业创新链项目(2022ZDLSF03-07)。

摘　　要：目的:探讨肌萎缩侧索硬化(ALS)患者血清鸢尾素(Irisin)、热休克蛋白70(HSP70)水平及其临床意义。方法:选取2017年1月-2020年12月中国人民解放军联勤保障部队第904医院神经内科收治的ALS患者62例,根据E1 Escorial诊断标准分为ALS早期组(n=30)和ALS晚期组(n=32),另选取同期在我院体检的健康志愿者58例为对照组,比较三组血清Irisin、HSP70水平,分析ALS患者血清Irisin、HSP70水平与氧化应激指标、改良后肌萎缩侧索硬化功能(ALSFRS-R)评分、爱丁堡认知行为量表(ECAS)评分和肌电图参数的相关性,采用受试者工作特征(ROC)曲线分析血清Irisin、HSP70对ALS的诊断效能。结果:与对照组比较,ALS早期组、ALS晚期组患者血清Irisin、HSP70、谷胱甘肽过氧化酶(GPX)、超氧化物歧化酶(SOD)水平明显降低,且ALS晚期组低于ALS早期组(P<0.05)。与对照组比较,ALS早期组、ALS晚期组患者血清8-羟基脱氧鸟苷酸(8-OHDG)、丙二醛(MDA)水平明显升高,且ALS晚期组高于ALS早期组(P<0.05);ALS晚期组ECAS评分、ALSFRS-R评分低于ALS早期组(P<0.05);与ALS早期组比较,ALS晚期组正中神经、尺神经、腓总神经以及胫神经的复合肌肉动作电位(CMAP)水平明显降低(P<0.05);Pearson检验结果显示,血清Irisin、HSP70水平与血清8-OHDG、MDA呈负相关(P<0.05),与血清GPX、SOD水平、ECAS评分、ALSFRS-R评分以及正中神经CMAP、尺神经CMAP、腓总神经CMAP、胫神经CMAP呈正相关(P<0.05);ROC曲线分析显示,Irisin、HSP70联合应用时曲线下面积(AUC)(0.95CI)为0.850(0.722~0.976),诊断效能较高。结论:ALS患者血清Irisin、HSP70水平与患者体内氧化应激的过度激活、认知功能及神经功能的损害相关,血清Irisin、HSP70有可能成为ALS诊断和病情评估的生物标记物之一。Objective:To investigate the levels of serum Irisin and heat shock protein 70(HSP70)in patients with amyotrophic lateral sclerosis(ALS)and their clinical significance.Methods:62 patients with ALS who werre admitted to Neurology Department of The 904 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army from January 2017 to December 2020 were selected,and they were divided into early ALS group(n=30)and late ALS group(n=32)according to E1 Escorial diagnostic criteria.58healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group.The levels of serum Irisin and HSP70 in the three groups were compared,and the correlation between the levels of serum Irisin and HSP70and oxidative stress indicators,amyotrophic lateral sclerosis functional rating scale revised(ALSFRS-R)score,Edinburgh cognitive and behavioral scale(ECAS)score and electromyogram parameters in patients with ALS were analyzed.The diagnostic efficacy of serum Irisin and HSP70 for ALS was analyzed by receiver operating characteristic(ROC)curve.Results:Compared with the control group,the levels of serum Irisin,HSP70,glutathione peroxidase(GPX)and superoxide dismutase(SOD)in the early ALS group and late ALS group were significantly decreased,and the levels in the late ALS group were lower than those in the early ALS group(P<0.05).Compared with the control group,the levels of serum 8-hydroxy-2 deoxyguanosine(8-OHDG)and malonaldehyde(MDA)in the early ALS group and late ALS group were significantly increased,and the levels in the late ALS group were higher than those in the early ALS group(P<0.05).The ECAS score and the ALSFRS-R score of the late ALS group was lower than that of the early ALS group(P<0.05).Compared with the early ALS group,the levels of compound muscle action potential(CMAP)of median nerve,ulnar nerve,common peroneal nerve and tibial nerve in the late ALS group were significantly lower(P<0.05).Pearson test results showed that the levels of serum Irisi

关 键 词：肌萎缩侧索硬化 鸢尾素 热休克蛋白70 氧化应激 认知功能 肌电图 诊断 

分 类 号：R746.4[医药卫生—神经病学与精神病学]