老年脑小血管病患者α-突触核蛋白和载脂蛋白A1表达水平与认知功能关系  

Relationship betweenα-synuclein and ApoA1 expression and cognitive function in elderly patients with cerebral small vessel disease

作　　者：魏丽君[1] 王佳琪 徐昶明[1] 杨腾超 和鹏飞 Wei Lijun;Wang Jiaqi;Xu Changming;Yang Tengchao;He Pengfei(Huludao City Center Hospital,Huludao 125000,China;Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Jinzhou Medical University Postgraduate Training Base,Huludao Central Hospital,Huludao 125000,China)

机构地区：[1]葫芦岛市中心医院神经内科,葫芦岛125000 [2]内蒙古科学技术大学包头医学院中心临床学院,包头014040 [3]锦州医科大学葫芦岛市中心医院研究生培养基地,葫芦岛125000

出　　处：《中华老年医学杂志》2024年第11期1426-1431,共6页Chinese Journal of Geriatrics

摘　　要：目的探究老年脑小血管病(CSVD)患者α-突触核蛋白(α-synuclein)、载脂蛋白A1(ApoA1)表达水平与认知功能的关系。方法回顾性选取2022年9月至2024年6月葫芦岛市中心医院收治的176例CSVD老年患者为研究对象, 根据患者入院时认知功能将其分为障碍组71例和正常组105例, 收集患者一般资料, 检测其α-synuclein、ApoA1血清表达水平。采用Pearson相关分析α-synuclein、ApoA1表达水平与蒙特利尔认知评估量表(MoCA)评分的相关性, 多因素Logistic回归分析筛选影响因素, 绘制受试者操作特征曲线(ROC曲线)分析α-synuclein、ApoA1血清水平的诊断价值。结果障碍组患者年龄大于正常组, MoCA评分、血清α-synuclein水平高于正常组, ApoA1水平低于正常组(均P<0.05)。Pearson相关分析发现, MoCA评分与α-synuclein表达呈负相关性, 与ApoA1表达呈正相关性(均P<0.05)。多因素Logistic回归分析结果显示:年龄、吸烟史、α-synuclein水平均为CSVD患者认知功能障碍的危险因素, ApoA1为CSVD患者认知功能的保护因素。经ROC曲线分析可得, 血清α-synuclein和ApoA1水平对患者认知功能障碍均有一定的诊断价值, 两者联合预测的AUC为0.836, 灵敏度和特异度分别为76.14%、78.14%。结论 CSVD合并认知功能障碍的老年患者α-synuclein表达异常偏高, ApoA1表达异常偏低, 两者均为CSVD老年患者合并认知功能障碍的影响因素, 其有助于认知功能障碍的诊断, 且联合诊断效能更高。Objective This study aims to investigate the expression levels ofα-synuclein(α-synuclein)and apolipoprotein A-1(ApoA1)in elderly patients with cerebral small vessel disease(CSVD)and their association with cognitive function.Methods A total of 176 elderly patients diagnosed with CSVD and admitted to Huludao Central Hospital between September 2022 and February 2024 were retrospectively selected as research subjects.Based on their cognitive function at the time of admission,patients were categorized into a disorder group comprising 71 cases and a normal group consisting of 105 cases.General information was collected from the patients,and the serum expression levels ofα-synuclein and ApoAl were measured.Pearson correlation analysis was employed to assess the relationship between the expression levels ofα-synuclein and ApoAl and the Montreal Cognitive Assessment(MoCA)scores.Furthermore,multi-factor logistic regression analysis was conducted to identify influencing factors,and receiver operating characteristic(ROC)curves were generated to evaluate the diagnostic value of serum levels.Results Patients in the disorder group were older than those in the normal group.Additionally,the MoCA score and serumα-synuclein levels were significantly higher in the disorder group,while ApoA1 levels were lower(all P<0.05).Pearson correlation analysis indicated that the MoCA scorewas negatively correlated withhα-synuclein expression and positively correlated with ApoA1 expression(all P<0.05).Multivariate logistic regression analysis revealed that age,smoking history,andα-synuclein levels are risk factors for cognitive dysfunction in patients with CSVD,whereas ApoA1 is identified as a protective factor for cognitive function in this population.Furthermore,ROC curve analysis demonstrated that serumα-synuclein and ApoAl levels possess diagnostic value for cognitive dysfunction in patients.The area under the curve(AUC)for the combined predictions was O.836,with sensitivity and specificity rates of 76.14%and 78.14%,respectively.Conc

关 键 词：载脂蛋白A Α突触核蛋白 脑小血管病 认知功能 蒙特利尔认知评估量表 

分 类 号：R743[医药卫生—神经病学与精神病学]