血清3-NT UCH-L1对帕金森病并发认知功能障碍的诊断效能分析  

Analysis of diagnostic efficacy of serum 3-NT and UCH-L1 in Parkinson’s disease with cognitive impairment

作　　者：王倩 刘丹 秦伟伟 张杰文[2] 袁艺铭 WANG Qian;LIU Dan;QIN Weiwei;ZHANG Jiewen;YUAN Yiming(Zhumadian Central Hospital,Zhumadian 463000,China;Henan Provincial People’s Hospital,Zhengzhou 450003,China;Nanyang Second People’s Hospital Affiliated to Xinxiang Medical College,Nanyang 473000,China)

机构地区：[1]驻马店市中心医院,河南驻马店463000 [2]河南省人民医院,河南郑州450003 [3]新乡医学院附属南阳市第二人民医院,河南南阳473000

出　　处：《中国实用神经疾病杂志》2024年第8期1028-1032,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20221058);河南省医学科技攻关计划联合共建项目(编号:LHGJ20191467);河南省医学科技攻关计划联合共建项目(编号:LHGJ20230962);南阳医学科技发展项目(编号:23KLGG160)。

摘　　要：目的探讨血清3-硝基酪氨酸(3-NT)、泛素C末端水解酶L1(UCH-L1)水平与帕金森病患者并发认知功能障碍的关系及其诊断价值。方法纳入驻马店市中心医院2020-07—2023-07诊治的104例帕金森病患者作为研究对象,根据蒙特利尔认知功能评估量表(MoCA)评分将患者分为认知功能正常组48例和认知功能障碍组56例。采用酶联免疫吸附法检测血清3-NT、UCH-L1水平,采用Pearson法分析帕金森病认知功能障碍患者血清3-NT、UCH-L1水平与MoCA评分的相关性,采用受试者工作特征(ROC)曲线分析血清3-NT、UCH-L1水平对帕金森病患者认知功能障碍的诊断价值,采用Logistic多因素回归分析帕金森病患者认知功能障碍的影响因素。结果认知功能障碍组血清3-NT[(7.26±2.04)μg/L比(4.58±1.40)μg/L]、UCH-L1[(0.94±0.21)μg/L比(0.62±0.16)μg/L]水平及H-Y分期中/晚期患者比例(78.57%比16.67%)高于认知功能正常组(P<0.05)。认知功能障碍组语言[(4.93±0.52)分比(5.23±0.49)分]、命名[(2.11±0.35)分比(2.46±0.34)分]、注意力[(4.80±0.67)分比(5.31±0.45)分]、抽象思维[(1.21±0.26)分比(1.63±0.20)分]、视空间及执行能力[(2.89±0.39)分比(3.54±0.30)分]、定向力[(5.11±0.48)分比(5.50±0.31)分]、延迟记忆[(2.88±0.36)分比(4.02±0.41)分]、MoCA总分[(23.93±2.05)分比(27.69±1.08)分]低于认知功能正常组(P<0.05)。帕金森病认知功能障碍患者血清3-NT、UCH-L1水平与语言、命名、注意力、抽象思维、视空间及执行能力、定向力、延迟记忆、MoCA总分均呈负相关(P<0.05)。3-NT、UCH-L1单独及其联合诊断帕金森病患者认知功能障碍的AUC分别为0.869、0.852、0.951。3-NT、UCH-L1、H-Y分期均是帕金森病患者并发认知功能障碍的独立危险因素(P<0.05)。结论血清3-NT、UCH-L1水平可用于评估帕金森病患者认知功能障碍的发生。Objective To investigate the relationship between serum levels of 3-nitro-1-tyrosine(3-NT)and ubiquitin C-terminal hydrolase L1(UCH-L1)and cognitive impairment in Parkinson’s disease patients and their diagnostic value.Methods A total of 104 Parkinson’s disease patients diagnosed and treated in the Zhumadian Central Hospital from July 2020 to July 2023 were included as the study subjects,according to the Montreal cognitive assessment(MoCA)score,the patients were grouped into the normal cognitive function group(48 cases)and the cognitive impairment group(56 cases).Enzyme linked immunosorbent assay(ELISA)was applied to detect serum 3-NT and UCH-L1 levels.Pearson method was applied to analyze the correlation between serum 3-NT,UCH-L1 levels and MoCA scores in Parkinson’s disease patients with cognitive impairment,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum 3-NT and UCH-L1 levels for cognitive impairment in Parkinson’s disease patients.Logistic multivariate regression was applied to analyze the influencing factors for cognitive impairment in Parkinson’s disease patients.Results The serum levels of 3-NT(7.26±2.04 vs 4.58±1.40),UCH-L1(0.94±0.21 vs 0.62±0.16),and the proportion of mid to late H-Y stage patients(78.57%vs 16.67%)in the cognitive impairment group were higher than those in the normal cognitive function group(P<0.05).The total scores of language(4.93±0.52 vs 5.23±0.49),naming(2.11±0.35 vs 2.46±0.34),attention(4.80±0.67 vs 5.31±0.45),abstract thinking(1.21±0.26 vs 1.63±0.20),visual space and executive ability(2.89±0.39 vs 3.54±0.30),directional ability(5.11±0.48 vs 5.50±0.31),delayed memory(2.88±0.36 vs 4.02±0.41),and MoCA(23.93±2.05 vs 27.69±1.08)in the cognitive impairment group were lower than those in the normal cognitive function group(P<0.05).The serum levels of 3-NT and UCH-L1 in Parkinson’s disease patients with cognitive impairment were negatively correlated with language,naming,attention,abstract thinking,visual

关 键 词：帕金森病 认知功能障碍 3-硝基酪氨酸 泛素C末端水解酶L1 血清 危险因素 

分 类 号：R742.5[医药卫生—神经病学与精神病学]