老年帕金森病患者外周血、胆红素、前列腺素E表达与疾病分级、快速眼动睡眠障碍的相关性  

The correlation between the expression of NFL,bilirubin and prostaglandin E in peripheral blood of elderly patients with Parkinson's disease and disease classification,rapid eye movement sleep disorder

作　　者：赵超 潘凯婷 徐浩 Zhao Chao;Pan Kaiting;Xu Hao(Department of Neurology,Shangluo Central Hospital,Shaanxi 726099,China)

机构地区：[1]商洛市中心医院神经内科,陕西726099 [2]宝鸡第三医院神经内科 [3]联勤保障部队第九八七医院神经内科

出　　处：《脑与神经疾病杂志》2024年第9期583-588,共6页Journal of Brain and Nervous Diseases

基　　金：陕西省重点研发项目(2020SF-188)。

摘　　要：目的 探讨老年帕金森病(PD)患者外周血神经丝轻链蛋白(NFL)、胆红素、前列腺素E表达与疾病分级、快速眼动睡眠障碍的相关性。方法 选取2020年1月至2022年10月在商洛市中心医院神经内科诊治的106例老年PD患者为研究对象,根据是否出现快速眼动睡眠障碍分为睡眠正常组和睡眠障碍组。收集患者的临床资料,比较不同疾病分级患者外周血NFL、胆红素、前列腺素E表达的区别,使用单因素和多因素Logistic回归分析外周血NFL、胆红素、前列腺素E表达、疾病分级及其他因素对老年PD患者快速眼动睡眠障碍发生的影响并构建患者睡眠障碍发生的风险预测模型,使用受试者工作特征(ROC)曲线评价该模型的预测性能。结果 不同疾病分期患者多周血NFL、胆红素及前列腺素E比较结果显示,早期组NFL及前列腺素E2均显著低于中晚期组,总胆红素显著高于中晚期组(^(均)P<0.05)。其中睡眠正常组41例(38.68%),睡眠障碍组65例(61.32%),多因素分析结果显示,两组患者NFL(OR=1.340,95%CI=1.035~1.736,P=0.027)、前列腺素E2 (OR=1.141,95%CI=1.052~1.237,P=0.001)、汉密尔顿焦虑量表(HAMA)(OR=1.378,95%CI=1.084~1.752,P=0.009)、汉密尔顿抑郁量表(HAMD)(OR=1.398,95%CI=1.092-1.790,P=0.008)为老年PD患者快速眼动睡眠障碍发生的独立影响因素(^(均)P<0.05)。在此基础上建立风险预测模型,模型公式:Logit(P)=-34.469+0.293×NFL+0.132×前列腺素E2+0.321×HAMA+0.335×HAMD。其ROC曲线下面积为0.992,95%CI:0.981~1.000,敏感度为0.969,特异度为0.951,Youden指数为0.920。结论 老年PD患者外周血NFL及前列腺素E表达均是其快速眼动睡眠障碍发生的独立影响因素,疾病分级及总胆红素未能纳入模型,可能与其他数据的干扰有关。Objective To investigate the correlation between the expression of neurofilament light chain(NFL),bilirubin and prostaglandin E in peripheral blood of elderly patients with Parkinson's disease(PD)and disease classification,rapid eye movement sleep disorder.Methods A total of 106 elderly patients with PD diagnosed and treated in the Department of Neurology,Shangluo Central Hospital from January 2020 to October 2022 were selected as the research objects.According to whether rapid eye movement sleep disorder occurred,they were divided into normal sleep group and sleep disorder group.According to whether there was rapid eye movement sleep disorder,they were divided into normal sleep group and sleep disorder group.The clinical data of patients were collected,and the differences in the expression of NFL,bilirubin and prostaglandin E in peripheral blood of patients with different disease grades were compared.Univariate and multivariate Logistic regression were used to analyze the effects of peripheral blood NFL,bilirubin,prostaglandin E expression,disease grade and other factors on the occurrence of rapid eye movement sleep disorder in elderly patients with PD,and the risk prediction model of sleep disorder was constructed.The ROC curve was used to evaluate the predictive performance of the model.Results The comparison of NFL,bilirubin and prostaglandin E in patients with different disease stages showed that NFL and prostaglandin E2 in the early group were significantly lower than those in the middle and late group,and total bilirubin was significantly higher than that in the middle and late group(allP<0.05).There were 41 cases(38.68%)in the normal sleep group and 65 cases(61.32%)in the sleep disorder group.NFL(OR=1.340,95%CI=1.035-1.736,P=0.027),prostaglandin E2(OR=1.141,95%CI=1.052-1.237,P=0.001),HAMA(OR=1.378,95%CI=1.084-1.752,P=0.009)and HAMD(OR=1.398,95%CI=1.092-1.790,P=0.008)were independent influencing factors of rapid eye movement sleep disorder in elderly patients with PD(allP<0.05).On this basis,a risk predict

关 键 词：神经丝轻链蛋白 胆红素 前列腺素E 疾病分级 快速眼动睡眠障碍 

分 类 号：R743.33[医药卫生—神经病学与精神病学]