血清claudin-5、JKAP在帕金森病患者中的表达水平及临床意义  

Expression levels of serum claudin-5 and JKAP in patients with Parkinson′s disease and their clinical significance

作　　者：边娜 刘倩 孙旸园 BIAN Na;LIU Qian;SUN Yangyuan(Department of Neurology,Bao Ji People′s Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院神经内科,宝鸡721000

出　　处：《中国临床新医学》2025年第2期153-158,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：陕西省科学技术研究发展计划项目(编号:2021K12-06)。

摘　　要：目的探讨血清封闭蛋白-5(claudin-5)、c-Jun氨基末端激酶激活蛋白(JKAP)在帕金森病(PD)患者中的表达水平及临床意义。方法选取2021年1月至2024年7月宝鸡市人民医院神经内科收治的85例PD患者(PD组)。根据Hoehn-Yahr分级将PD患者分为早期PD组(1~2.5级,17例)、中期PD组(3级,41例)、晚期PD组(4~5级,27例)。另选取该院同期体检健康的85名志愿者作为对照组。采用酶联免疫吸附试验检测血清claudin-5、JKAP水平。根据PD认知功能评定量表(PD-CRS)评分将PD患者分为正常认知组(>80分,28例)、PD轻度认知障碍(PD-MCI)组(74~80分,37例)和PD痴呆(PDD)组(<74分,20例)。其中,PD-MCI和PDD都属于PD认知障碍。采用Spearman秩相关分析claudin-5、JKAP水平与PD患者Hoehn-Yahr分级的相关性。采用多因素logistic回归分析PD患者发生认知障碍的影响因素。通过受试者工作特征(ROC)曲线分析claudin-5、JKAP水平对PD患者认知障碍和PDD的诊断效能。结果与对照组比较,PD组claudin-5水平较高,JKAP水平较低,差异有统计学意义(P<0.05)。早期PD组、中期PD组、晚期PD组claudin-5水平依次升高,JKAP水平依次降低,差异有统计学意义(P<0.05)。PD患者Hoehn-Yahr分级与claudin-5水平呈正相关(rs=0.810,P<0.001),与JKAP水平呈负相关(rs=-0.823,P<0.001)。正常认知组、PD-MCI组、PDD组病程依次延长,claudin-5水平依次升高,JKAP水平依次降低,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,较高的claudin-5水平是PD患者发生认知障碍的独立危险因素(P<0.05),较高的JKAP水平是PD患者发生认知障碍的独立保护因素(P<0.05)。ROC曲线分析结果显示,claudin-5、JKAP水平联合诊断PD患者认知障碍[AUC(95%CI)=0.894(0.808~0.950)]以及联合诊断PDD[AUC(95%CI)=0.901(0.793~0.964)]的效能较单一指标更高(P<0.05)。结论PD患者血清claudin-5水平升高、JKAP水平降低,与病情加重和认知障碍相关,两项指标联合检测有助于Objective To explore the expression levels of serum claudin-5 and c-Jun N-terminal kinase activating protein(JKAP)in patients with Parkinson′s disease(PD)and their clinical significance.Methods A total of 85 PD patients(PD group)admitted to the Department of Neurology of Bao Ji People′s Hospital from January 2021 to July 2024 were selected.According to Hoehn-Yahr classification,the PD patients were divided into early stage PD group(grade 1-2.5,17 cases),middle stage PD group(grade 3,41 cases),and late stage PD group(grade 4-5,27 cases).Other 85 volunteers who underwent physical examination in Bao Ji People′s Hospital during the same period were selected as the control group.The levels of claudin-5 and JKAP in serum were detected by using enzyme-linked immunosorbent assay.According to the scores of PD-Cognitive Rating Scale(PD-CRS),the PD patients were divided into normal cognitive group(>80 points,28 cases),PD mild cognitive impairment(PD-MCI)group(74-80 points,37 cases)and PD dementia(PDD)group(<74 points,20 cases).Among them,PD-MCI and PDD belonged to PD cognitive impairment.Spearman rank correlation was used to analyse the correlation of claudin-5 and JKAP levels with the PD patients′Hoehn-Yahr grades.Multivariate logistic regression was used to analyze the influencing factors of cognitive impairment in the PD patients.The efficacy of claudin-5 and JKAP levels for diagnosing cognitive impairment and PDD in the PD patients was analyzed by using receiver operating characteristic(ROC)curve.Results Compared with the control group,the PD group had higher level of claudin-5 and lower level of JKAP,and the differences were statistically significant(P<0.05).The levels of claudin-5 in the early stage PD group,the middle stage PD group and the late stage PD group were increased in order,while the levels of JKAP in the early stage PD group,the middle stage PD group and the late stage PD group were decreased in order,and the differences were statistically significant(P<0.05).The Hoehn-Yahr grade in the PD patients

关 键 词：帕金森病 封闭蛋白-5 c-Jun氨基末端激酶激活蛋白 认知功能 

分 类 号：R742.5[医药卫生—神经病学与精神病学]