帕金森患者外周血Toll样受体3表达水平与周围神经病变的相关性研究  

Correlation between toll-like receptor 3(TLR3)expression in peripheral blood and peripheral neuropathy in patients with Parkinson′s disease

作　　者：张冬梅 刁艳博 王增宝 李玮 ZHANG Dongmei;DIAO Yanbo;WANG Zengbao;LI Wei(Department of Neurology,The First People′s Hospital of Heihe,Heihe Heilongjiang 164300,China;Department of Neurology,Shanxi Provincial People′s Hospital,Taiyuan 030000,China)

机构地区：[1]黑河市第一人民医院神经内科,黑龙江黑河164300 [2]山西省人民医院神经内科,太原030000

出　　处：《新疆医科大学学报》2024年第8期1086-1090,共5页Journal of Xinjiang Medical University

基　　金：山西省基础研究计划项目(202203021221355)。

摘　　要：目的研究帕金森患者外周血Toll样受体3(Toll-like receptor 3,TLR3)表达与周围神经病变的相关性。方法选取2023年1月-12月在黑河市第一人民医院神经内科就诊并治疗的112例帕金森患者为帕金森组,纳入同期在本院进行健康体检的120例老年体检者为健康对照组。采用实时荧光定量聚合酶链反应检测所有研究对象外周血TLR3的表达水平。对帕金森患者进行肌电图检查,判断是否存在周围神经病变。采用修订的Hoehn-Yahr(H-Y)分级评估帕金森患者的病情严重程度。结果与健康对照组比较,帕金森组外周血TLR3表达水平显著升高,差异有统计学意义(t=7.341,P<0.001)。112例帕金森患者中,发生周围神经病变50例,未发生周围神经病变62例。与无周围神经病变组比较,周围神经病变组外周血TLR3表达水平显著升高,差异有统计学意义(t=4.632,P<0.001)。二元多因素Logistic回归分析结果表明,较高的H-Y分级、左旋多巴日剂量、同型半胱氨酸和外周血TLR3水平及较低的维生素B 12水平是帕金森合并周围神经病变的独立危险因素(P<0.05)。帕金森患者外周血TLR3表达水平与感觉神经神经传导速度(Nerve conductive velocity,NCV)、运动神经NCV呈负相关关系(r分别为-0.398和-0.442,P均<0.001)。ROC曲线分析表明,外周血TLR3表达水平评估帕金森病合并周围神经病变的曲线下面积为0.879(0.817~0.942),灵敏度为92.0%,特异度为71.0%。结论外周血TLR3表达水平在帕金森合并周围神经病变组中显著升高,与神经NCV显著负相关,对帕金森合并周围神经病变的诊断具有一定价值。Objective:To investigate the correlation between toll-like receptor 3(TLR3)expression and peripheral neuropathy in patients with Parkinson′s disease.Methods:112 patients with Parkinson′s disease who were treated in the hospital from January 2023 to December 2023 were selected as Parkinson′s disease group,and 120 elderly patients who underwent physical examination in the hospital during the same period were included as healthy control group.The expression levels of TLR3 in peripheral blood of all subjects were detected by real-time fluorescence quantitative polymerase chain reaction.The patients with Parkinson′s disease were examined by electromyography to determine whether peripheral neuropathy was present.The severity of Parkinson′s disease was assessed using a revised Hoehn-Yahr(H-Y)scale.Results:Compared with healthy control group,TLR3 expression level in peripheral blood of Parkinson′s disease group was significantly increased,and the difference was statistically significant(t=7.341,P<0.001).Among 112 patients with Parkinson′s disease,there were 50 patients with peripheral neuropathy and 62 patients without peripheral neuropathy.Compared with the non-peripheral neuropathy group,TLR3 expression level in peripheral blood of the peripheral neuropathy group was significantly increased,and the difference was statistically significant(t=4.632,P<0.001).Binary Logistic regression analysis showed that higher H-Y grade,daily dose of levodopa,homocysteine,TLR3 level in peripheral blood and lower vitamin B 12 level were independent risk factors for Parkinson′s disease complicated with peripheral neuropathy(P<0.05).The expression level of TLR3 in peripheral blood of PD patients was negatively correlated with nerve conductive velocity(NCV)and motor nerve NCV(r were-0.398 and-0.442,respectively,P<0.001).ROC curve analysis showed that the area under the curve of peripheral blood TLR3 expression level in the assessment of Parkinson′s disease complicated with peripheral neuropathy was 0.879(0.817~0.942),the s

关 键 词：帕金森 周围神经病变 TOLL样受体3 神经传导速度 

分 类 号：R741[医药卫生—神经病学与精神病学]