应用血清RANTES、MIF构建帕金森病并发认知功能障碍预测模型的价值分析  

Analysis of a model based on serum RANTES and MIF for prediction of cognitive dysfunction in patients with Parkinson disease

作　　者：王菲 张娟利 WANG Fei;ZHANG Juanli(Department of Neurology,Xd Group Hospital,Xi′an 710077,China)

机构地区：[1]西电集团医院神经内科,陕西西安710077

出　　处：《中风与神经疾病杂志》2023年第6期544-548,共5页Journal of Apoplexy and Nervous Diseases

摘　　要：目的研究确认血清活化T细胞趋化因子(activated T cell chemokine,RANTES)和巨噬细胞游走抑制因子(macrophage migration inhibitor,MIF)对帕金森病(Parkinson disease,PD)并发认知功能障碍的预测价值。方法选择2020年1月-2022年1月到西电集团医院进行治疗的62例帕金森患者作为研究对象。患者均接受5个月左旋多巴制剂治疗酶联免疫吸附法对RANTES、MIF、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平进行检测。结果经过5个月左旋多巴制剂治疗后,在62例PD患者中有21例患者出现认知功能障碍,认知功能障碍发生率为33.87%。相对于认知功能发生组,未发生组患者的TNF-α、MIF、IL-6和RANTES水平高(P<0.05)。将患者全部基本资料纳入协变量,因变量为是否发生认知功能障碍,建立多元回归模型,对帕金森病家族史、临床分型、合并高血压、吸烟史、病程、性别和年龄进行校正,结果显示血清RANTES、MIF、IL-6和TNF-α水平是PD患者出现认知功能障碍的独立影响因素(P<0.05)。ROC结果显示血清RANTES水平对PD患者认知功能障碍预测的AUC为0.798,特异度、敏感度和约登指数分别为0.743、0.705和0.448。血清MIF水平对PD认知功能障碍预测的AUC为0.802,特异度、敏感度和约登指数分别为0.552、0.973和0.525。联合血清RANTES和MIF绘制ROC曲线,分析结果表明血清MIF和RANTES联合对PD患者认知功能障碍预测的AUC为0.958。结论血清RANTES、MIF高水平是PD患者并发认知功能障碍危险因素,临床中可通过检测血清RANTES、MIF水平预测患者认知功能障碍发生风险,已进行早期干预治疗。Objective To study the value of regulated upon activation,normal T-cell expressed and secreted(RANTES)and macrophage migration inhibitory factor(MIF)in the prediction of cognitive dysfunction associated with Parkinson disease(PD).Methods A total of 62 PD patients who received treatment in our hospital from January 2020 to January 2022 were recruited.All patients were treated with levodopa for 5 months.The levels of RANTES,MIF,interleukin-6(IL-6),and tumor necrosis factor(TNF)-αwere measured by enzyme-linked immunosorbent assay.Results Among the 62 PD patients,21(33.87%)developed cognitive dysfunction after 5 months of levodopa treatment.The levels of RANTES,MIF,IL-6,and TNF-αwere significantly lower in patients with cognitive dysfunction than in those without cognitive dysfunction(P<0.05).A multiple regression model was established with the basic data of patients as covariates and the presence or absence of cognitive dysfunction as the dependent variable.Adjustment was made for family history of PD,clinical subtype,comorbidity of hypertension,smoking history,course of disease,sex,and age.The results showed that serum RANTES,MIF,IL-6,and TNF-αlevels were independent risk factors for cognitive dysfunction in PD patients(P<0.05).The receiver operating characteristic(ROC)curve showed an area under the ROC curve(AUC)of 0.798 for serum RANTES level to predict cognitive dysfunction in PD patients,with specificity,sensitivity,and Youden index of 0.743,0.705,and 0.448,respectively.The AUC was 0.802 for serum MIF level in the prediction of cognitive dysfunction in PD patients,with specificity,sensitivity,and Youden index of 0.552,0.973,and 0.525,respectively.The combination of serum RANTES and MIF had an AUC of 0.958 in predicting cognitive dysfunction in PD patients.Conclusion High levels of serum RANTES and MIF are risk factors for cognitive dysfunction in PD patients.In clinical practice,serum RANTES and MIF levels can be determined to predict the risk of cognitive dysfunction for early intervention and treatment.

关 键 词：巨噬细胞游走抑制因子 活化T细胞趋化因子 帕金森病 认知功能障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学]