创伤与急危重病医学

目的探讨帕金森病(PD)患者血清脑源性神经营养因子前体蛋白(pro-BDNF)水平,分析其与病情严重程度、认知障碍的关系。方法选取海南省干部疗养院(海南省老年病医院)自2017年7月至2019年7月收治的110例PD患者为PD组,选取同期于我院体检的89例健康者为健康组。两组均采血检测血清pro-BDNF水平,采用蒙特利尔认知评估量表(MoCA)评估认知功能。根据Hoehn-Yahr(H-Y)分期将PD患者分为1期组(n=38)、2～3期组(n=51)、4～5期组(n=21),比较3组血清pro-BDNF水平及MoCA评分。根据MoCA评分将PD患者分为认知障碍组(n=46)与非障碍组(n=64),比较两组血清pro-BDNF水平、H-Y分期。采用Pearson线性相关分析血清pro-BDNF水平与H-Y分期、MoCA评分的相关性。结果 PD组血清pro-BDNF水平高于健康组,MoCA各维度评分及总分均低于健康组,差异有统计学意义(P<0.05)。2～3期组、4～5期组血清pro-BDNF水平高于1期组,且4～5期组高于2～3期组,差异有统计学意义(P<0.05)。2～3期组、4～5期组MoCA各维度评分及总分低于1期组,且4～5期组低于2～3期组,差异有统计学意义(P<0.05)。认知障碍组血清pro-BDNF水平、H-Y分期高于非障碍组,差异有统计学意义(P<0.05)。经Pearson线性相关分析显示,血清pro-BDNF水平与H-Y分期呈正相关,与视空间与执行功能、命名、注意力、语言、延迟回忆、定向力评分及MoCA总分呈负相关(P<0.05);血清pro-BDNF水平与抽象评分无相关性(P>0.05)。结论 pro-BDNF在PD患者血清中呈高水平表达,与患者的H-Y分期、MoCA评分均有相关性,可能成为临床评估PD进展的重要指标。

Objective To explore the level of serum precursor of brain-derived neurotrophic factor(pro-BDNF)in patients with Parkinson′s disease(PD),and analyze its relationship with severity and cognitive impairment.Methods A retrospective study was performed on 110 patients with PD admitted to Hainan cadre sanatorium(Hainan geriatric hospital)from July 2017 to July 2019,who were selected as PD group.Meanwhile, 89 healthy people were selected as healthy group during the same period.The level of serum pro-BDNF was detected in both groups, and the cognitive function was assessed by Montreal Cognitive Assessment Scale(MoCA).According to Hoehn Yahr(H-Y)stage, PD patients were divided into 1 stage group(n=38),2-3 stage group(n=51)and 4-5 stage group(n=21).Serum pro-BDNF level and MOCA score were compared among the three groups.According to MOCA score, PD patients were divided into cognitive impairment group(n=46)and non-impairment group(n=64).Serum pro-BDNF level and H-Y stage were compared between the two groups.Pearson linear correlation was used to analyze the correlation of serum Pro-BDNF level with H-Y staging and MOCA score.Results The serum pro-BDNF level of the PD group was higher than that of the healthy group, and all dimensions of MoCA scores and total scores were lower than those of the healthy group, the difference was statistically significant(P<0.05).The serum pro-BDNF levels of the 2-3 stage group and 4-5 stage group were higher than those of the 1 stage group, and the 4-5 stage group higher than the 2-3 stage group, the differences were statistically significant(P<0.05).The all dimensions of MoCA scores and total scores of the 2-3 stage group and the 4-5 stage group were lower than those of the 1 stage group, and the 4-5 stage group lower than the 2-3 stage group, the differences were statistically significant(P<0.05).The serum pro-BDNF level and H-Y staging of the cognitive impairment group were higher than those of the non-disabled group, and the differences were statistically significant(P<0.05).Pearson linear correlation analysis showed that serum pro-BDNF level was positively correlated with H-Y staging, and negatively correlated with visual space and executive function, naming, attention, language, delayed recall, orientation score and MoCA total score(P<0.05).There was no correlation between the serum pro-BDNF level and abstract score(P>0.05).Conclusion Serum pro-BDNF is highly expressed in PD patients, which is correlated with the patients′ H-Y stage and MoCA scores.It may become an important indicator for clinical evaluation of PD progression.