血清三磷酸腺苷结合盒转运蛋白A7、锌-α-2-糖蛋白水平联合检测对帕金森病患者认知障碍的评估价值OA
The evaluation value of combined detection of serum adenosine triphosphate-binding cassette transporter A7 and zinc-α2-glycoprotein for cognitive impairment in patients with Parkinson's disease
目的 探讨血清三磷酸腺苷结合盒转运蛋白A7(ABCA7)、锌-α-2-糖蛋白(ZAG)水平联合检测对帕金森病(PD)患者认知障碍的评估价值.方法 选择纳入2023 年1 月至2024 年7 月期间于本院就诊接受治疗的108 例PD患者为研究组,依据疾病进展分为早期亚组、中期亚组和晚期亚组,依据认知功能分为非认知障碍亚组和认知障碍亚组;同时期纳入性别、年龄匹配的 110 名本院体检中心健康体检者作为对照组.采用ELISA法检测血清ABCA7、ZAG水平;采用多因素Logistic回归分析独立影响因素;绘制ROC曲线分析指标评估价值;采用Bootstrap法对原始数据样本进行多重抽样内部验证联合评估模型.结果 与对照组相比,研究组血清ABCA7、ZAG水平均显著升高,蒙特利尔认知评估量表(MoCA)评分、MMSE评分均显著降低(均P＜0.001).早期亚组、中期亚组、晚期亚组患者血清ABCA7、ZAG水平及PD病程依次升高,MoCA、MMSE评分依次降低,组间比较差异有统计学意义(均P＜0.05).与非认知障碍亚组相比,认知障碍亚组PD病程及血清ABCA7、ZAG水平均显著升高,MoCA评分、MMSE评分显著降低(均P＜0.001).血清ABCA7、ZAG水平是PD患者认知障碍的独立影响因素(均P＜0.05).血清ABCA7、ZAG水平单独评估PD患者认知障碍的ROC曲线下面积(AUC)分别为 0.849、0.833,联合预测模型评估的AUC为 0.964,联合预测模型的AUC明显更高(Z1=2.329,Z2=3.078;P＜0.05).内部验证校准曲线结果显示,校准曲线和理想曲线基本一致,Hosmer-Lemeshow拟合优度检验χ2=7.015,P＞0.05.结论 PD患者中血清ABCA7、ZAG水平较高与认知障碍的风险相关,二者联合可作为PD患者认知障碍的辅助生物标志物.
Objective To discuss the evaluation value of combined detection of serum adenosine triphosphate-binding cassette transporter A7(ABCA7)and zinc-α2-glycoprotein(ZAG)for cognitive impairment in patients with Parkinson's disease(PD).Methods Totally 108 patients with PD who received treatment at our hospital from January 2023 to July 2024 were included in the study group.They were assigned into early subgroup,middle subgroup,and late subgroup based on disease progression,and assigned into non cognitive impairment subgroup and cognitive impairment subgroup based on cognitive function.Meantime,110 healthy examinees from our hospital's physical examination center and matched for gender and age were included as the control group.ELISA method was implemented to measure serum ABCA7 and ZAG levels.Multivariate Logistic regression was used to discuss independent influencing factors.ROC curve was used to discuss the evaluation value of indicators.In addition,Bootstrap method was implemented to perform multiple sampling on the original data samples for internal validation of the combined evaluation model.Results Compared with the control group,the serum levels of ABCA7 and ZAG in the study group were prominently higher,while the Montreal cognitive assessment(MoCA)score and MMSE score were prominently lower(all P＜0.001).The serum levels of ABCA7,ZAG and PD duration increased sequentially in the early,middle,and late subgroups,while MoCA score and MMSE score decreased sequentially,with statistical differences(all P＜0.05).Compared with the non cognitive impairment subgroup,the PD duration and serum levels of ABCA7 and ZAG in the cognitive impairment subgroup were obviously higher,while the MoCA score and MMSE score were obviously lower(all P＜0.001).The serum levels of ABCA7 and ZAG were independent influencing factors for cognitive impairment in PD patients(all P＜0.05).The AUC values of serum ABCA7 and ZAG levels individually in evaluating cognitive impairment of PD patients were 0.849 and 0.833,respectively.The ROC area under the curve(AUC)of combined prediction model was 0.964,and was obviously higher(Z1=2.329,Z2=3.078;P＜0.05).The internal validation calibration curve results showed that the calibration curve was basically consistent with the ideal curve,and the Hosmer-Lemeshow goodness of fit test showed χ2=7.015,P＞0.05.Conclusions Elevated serum levels of ABCA7 and ZAG are associated with the risk of cognitive impairment in PD patients.The combination of the two can serve as an auxiliary biomarker for cognitive impairment in PD patients.
张彧;王静;陈静
710068 西安,陕西省康复医院神经内科空军军医大学唐都医院检验科710068 西安,陕西省康复医院神经内科
医药卫生
帕金森病认知障碍三磷酸腺苷结合盒转运蛋白A7锌-α-2-糖蛋白
Parkinson's diseasecognitive impairmentadenosine triphosphate-binding cassette transporter A7zinc-α2-glycoprotein
《临床神经病学杂志》 2026 (2)
98-103,6
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