帕金森病患者和健康对照者的纵向CSF生物标志物对比研究

目的 探讨帕金森病(Parkinson's disease,PD)患者脑脊液(CSF)生物标志物的水平变化及其临床意义。方法 选取本院2018年3月-2019年3月收治的70例PD患者,并根据改良PD综合评分量表(UPDRS量表)及Hoehn-Yahr评分标准将患者分为轻度组(n=38)、中度组(n=18)和重度组(n=14)。另选择同期于本院接受体检健康人员70例作为对照组,检测并比较4组研究对象CSF生物标志物蛋白α-突触核蛋白(α-syn)、磷酸化Tau蛋白(P-Tau)及总Tau蛋白(T-Tau),微小RNA133 b(miR-133b)及C反应蛋白(CRP)、白细胞介素-8(IL-8)水平。结果 各组性别、年龄比较无明显差异(P>0.05); 不同病情严重程度PD患者UPDRS评分比较有明显差异,且均显著高于对照组(P<0.05); PD患者轻度组、中度组及重度组H-Y评分比较有明显差异(P<0.05)。各组α-syn、P-Tau、T-Tau、miR-133b、CRP及IL-8水平比较有明显差异(P<0.05),且随着PD患者病情严重程度加重,α-syn水平显著降低,P-Tau、T-Tau、miR-133b、CRP及IL-8水平显著升高(P<0.05)。Pearson相关分析显示,α-syn与UPDRS评分呈显著正相关,P-Tau、T-Tau、miR-133b、CRP及IL-8与UPDRS呈显著负相关(P<0.05)。受试者工作曲线(ROC)显示α-syn、P-Tau、T-Tau、miR-133b、CRP及IL-8水平诊断PD的曲线下面积(AUC)分别为0.755、0.785、0.742、0.746、0.779、0.755,联合诊断的AUC为0.905。结论 脑脊液生物标志物的水平变化是PD发生与发展的重要参考指标,其对于PD的诊断和病情严重程度判断具有重要价值

Comparative study of longitudinal CSF biomarkers in patients with Parkinson's disease and healthy controls

ObjectiveTo explore the changes and clinical significance of cerebrospinal fluid(CSF)biomarker levels in patients with Parkinson's disease(PD).Methods Seventy patients with PD who were admitted to our hospital from March 2018 to March 2019 were enrolled. The patients were divided into mild group(n=38), moderate group(n=18)and severe group(n=14)according to the modified PD comprehensive score scale(UPDRS scale)and Hoehn-Yahr score, and another 70 healthy subjects in our hospital were selected as the control group. The CSF biomarker proteins[nucleoprotein(α-syn), phosphorylated Tau protein(P-Tau)and total Tau protein(T-Tau), microRNA 133b(miR-133b)and C-reactive protein(CRP), interleukin-8(IL- 8)] were detected and compared among the four groups.Results There were no significant differences in gender and age among all groups(P>0.05). The difference of UPDRS score among the patients with different severity of PD was statistically significant, and The UPDRS score of the patients with different severity of PD were significantly higher than that of the control group(P<0.05). The difference of HY score among the mild group, the moderate group and the severe group was statistically significant(P<0.05). The differences of α-syn, P-Tau, T-Tau, miR-133b, CRP and IL-8 levels among all groups were statistically significant(P<0.05), and with the aggravation of disease in PD patients, the level of α-syn was significantly decreased,the levels of P-Tau, T-Tau, miR-133b, CRP and IL-8 were significantly increased(P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between α-syn and UPDRS score, and P-Tau, T-Tau, miR-133b, CRP and IL-8 were significantly negatively correlated with UPDRS score(P<0.05). The receiver operating curve(ROC)showed that the area under the curve(AUC)of diagnostic PD for α-syn, P-Tau, T-Tau, miR-133b, CRP, and IL-8 respectively were 0.755, 0.785, 0.742, 0.746, 0.779 and 0.755, the combined diagnosis AUC was 0.905.Conclusion The changes of cerebrospinal fluid biomarkers were important parameters for the occurrence and development of PD diseases, which were of great value for the diagnosis and judgment of PD.