帕金森病患者脑白质病变程度与血浆神经轴突导向因子1的相关性

Correlation between the severity of cerebral white matter lesion and the plasma level of netrin-1 in patients with PD

摘要:

目的 探讨帕金森病（PD）患者脑蛋白质病变程度与血浆神经轴突导向因子1（Netrin-1）的相关性。方法 选取2018年1月—2021年12月在南京医科大学附属无锡人民医院治疗的PD患者100例（PD组）。另取同期该院健康体检者100例作为对照组。比较两组血浆Netrin-1水平，分析不同脑白质病变程度PD患者血浆Netrin-1、H-Y分级、UPDRS-Ⅲ评分和MMSE评分。结果 PD组血浆Netrin-1低于对照组（P <0.05）。PD组H-Y分级、UPDRS-Ⅲ评分和MMSE评分中重度患者高于正常或轻度患者（P <0.05）。中重度PD患者H-Y分级、UPDRS-Ⅲ评分高于正常或轻度患者（P <0.05），血浆Netrin-1、MMSE评分低于正常或轻度患者（P <0.05）。血浆Netrin-1水平与脑白质病变程度（r_s =-0.574、P =0.003）、UPDRS-Ⅲ评分（r =-0.379，P =0.012）呈负相关，与MMSE评分呈正相关（r =0.377，P =0.010），与H-Y分级无相关性（r =0.110，P =0.223）。血浆Netrin-1水平诊断中重度脑白质病变的截断值为123.67 ng/L，ROC曲线下面积为0.856（95% CI：0.785，0.928），敏感性和特异性分别为81.60%（95% CI：0.725，0.892）和78.40%（95% CI：0.703，0.885）。结论 PD患者血浆Netrin-1水平明显降低，与患者脑白质病变程度呈负相关，在诊断脑白质病变程度方面有一定应用价值。

Abstract:

Objective To explore the correlation between the severity of cerebral white matter lesion and the plasma level of netrin-1 in patients with Parkinson's disease (PD).Methods A hundred of PD patients who were treated in our hospital from January 2018 to December 2021 were selected (PD group), and 100 healthy people undergoing heath checkup in our hospital during the same period were included as the control group. The plasma level of netrin-1 was compared between the two groups, and the plasma level of netrin-1, the stage on Hoehn and Yahr Scale, the Unified Parkinson's Disease Rating Scale (UPDRS)-Ⅲ score and the Mini-Mental State Examination (MMSE) score of PD patients with different severity of white matter lesions were analyzed.Results The plasma level of netrin-1 in the PD group was lower than that in the control group (P < 0.05). The stage on Hoehn and Yahr Scale and the UPDRS-III score of moderate to severe patients in the PD group were higher than those of normal or mild patients (P < 0.05). The plasma level of netrin-1 and the MMSE score of moderate to severe patients in the PD group were lower than those of normal or mild patients (P < 0.05). The plasma level of netrin-1 was negatively correlated with the severity of white matter lesions (r_s = -0.574, P = 0.003) and the UPDRS III score (r_s = -0.379, P = 0.012), and was positively correlated with the MMSE score (r = 0.377, P = 0.010), but was not correlated with the stage on Hoehn and Yahr Scale (r_s = 0.110, P = 0.223). The cut-off value of the plasma level of netrin-1 for diagnosing moderate to severe white matter lesions was 123.67 ng/L, with an area under the receiver operating characteristic (ROC) curve of 0.856 (95% CI: 0.785, 0.928), a sensitivity of 81.60% (95% CI: 0.725, 0.892), and a specificity of 78.40% (95% CI: 0.703, 0.885), respectively.Conclusions The plasma level of netrin-1 is significantly decreased in PD patients, and is negatively correlated with the severity of white matter lesions. Thus, it is of value in diagnosing the severity of white matter lesions in PD patients.