血清IGF-1、IDE、APOE-4水平在帕金森病中的临床诊断价值研究  

Clinical diagnostic value of serum IGF-1,IDE and APOE-4 levels in Parkinson′s disease

作　　者：许叶 李秋萍 许苗菁 马媛媛 赵振强[1,2] 王埮[1,2] 陈志斌[1,2] XU Ye;LI Qiuping;XU Miaojing;MA Yuanyuan;ZHAO Zhenqiang;WANG Tan;CHEN Zhibin(The First Clinic Medicine School of Hainan Medical College,Haikou,Hainan 570102,China;Department of Neurology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)

机构地区：[1]海南医学院第一临床学院,海南海口570102 [2]海南医学院第一附属医院神经内科,海南海口570102

出　　处：《国际检验医学杂志》2023年第5期548-552,560,共6页International Journal of Laboratory Medicine

基　　金：海南省高等学校科学研究项目(hnky2021-43);国家自然科学基金委员会项目(81860243)。

摘　　要：目的研究血清胰岛素降解酶(IDE)、胰岛素样生长因子-1(IGF-1)及载脂蛋白-4(APOE-4)水平在帕金森病(PD)中的临床诊断价值。方法选取2019年12月至2020年11月于该院治疗的PD患者70例(PD组)和同期在该院体检健康者85例(对照组)作为研究对象。采用修订Hoehn-Yahr(H-Y)分级对PD组进行评估分为早期组、中-晚期组。记录研究对象年龄、性别、生活习惯等一般资料,并检测各组血清IDE、IGF-1及APOE-4水平。比较对照组、早期组、中-晚期组血清IDE、IGF-1及APOE-4水平,分析血清IDE、IGF-1及APOE-4水平两两之间的相关性及其与统一帕金森氏病评分量表(UPDRS)评分、H-Y分级及日常生活能力量表(ADL)评分的相关性,采用Logistic多因素分析影响PD患者病情严重程度的危险因素。结果PD组IGF-1、APOE-4水平相较于对照组升高,而IDE水平相较于对照组下降,差异有统计学意义(P<0.05)。早期组、中-晚期组的APOE-4水平相较于对照组升高,而IDE水平相较于对照组下降,差异有统计学意义(P<0.05);中-晚期组APOE-4水平相较于早期组升高,而IGF-1、IDE水平相较于早期组下降,差异有统计学意义(P<0.05)。中-晚期组ADL评分明显低于早期组,而UPDRS各部分评分均高于早期组,差异有统计学意义(P<0.05)。PD组中IDE与IGF-1之间呈正相关(r=0.403,P=0.001),而APOE-4和IDE、IGF-1之间均无相关(r=-0.022,P=0.857;r=-0.167,P=0.166)。Logistic多因素分析发现,IDE、APOE-4为影响PD患者病情严重程度的独立危险因素(P<0.05)。结论血清IGF-1、APOE-4、IDE水平与PD发病及病情进展关系密切,检测3种指标水平对于预测PD早期发病有帮助,且结合其在血清中水平改变,对判定PD病情发展意义重大。Objective To study the clinical diagnostic value of serum insulin degrading enzyme(IDE),insulin-like growth factor-1(IGF-1)and apolipoprotein-4(APOE-4)levels in Parkinson′s disease(PD).Methods 70 patients with PD treated in this hospital from December 2019 to November 2020(PD group)and 85 healthy patients in this hospital during physical examination(control group)were selected as research objects.Modified Hoehn-Yahr(H-Y)grading was used to evaluate PD group,which was divided into early group and middle-late group.General information such as age,sex and living habits of the subjects were recorded,and serum IDE,IGF-1 and APOE-4 levels were detected in each group.The serum levels of IDE,IGF-1 and APOE-4 in control group,early group and middle-advanced group were compared,and the correlation between serum IDE,IGF-1 and APOE-4 levels and their correlation with the Unified Parkinson′s Disease Scale(UPDRS)score,H-Y scale and Activity of Daily Living Scale(ADL)score was analyzed.Logistic multivariate analysis was used to analyze the risk factors affecting the severity of PD patients.Results The level of IGF-1 and APOE-4 in PD group was higher than that in control group,while the level of IDE was lower than that in control group,the difference was statistically significant(P<0.05).The level of APOE-4 in the early and middle-late groups was higher than that in the control group,but the level of IDE was lower than that in the control group,the difference was statistically significant(P<0.05).The level of APOE-4 in the middle-late group was higher than that in the early group,while the levels of IGF-1 and IDE were lower than that in the early group,with statistical significance(P<0.05).The ADL score of the middle-late group was significantly lower than that of the early group,while the UPDRS scores of all parts were higher than those of the early group,with statistical significance(P<0.05).There was a positive correlation between IDE and IGF-1 in PD group(r=0.403,P=0.001),but no correlation between APOE-4 and IDE and IGF

关 键 词：胰岛素降解酶 帕金森病 载脂蛋白-4 胰岛素样生长因子-1 

分 类 号：R742.5[医药卫生—神经病学与精神病学]