老年帕金森病患者血清HIF-1α和LncRNA BACE1-AS表达变化与临床分期及认知功能障碍的关系研究OA
Study on the Relationship between Changes in Serum HIF-1α and LncRNA BACE1-AS Expression with Clinical Staging and Cognitive Impairment in Elderly Parkinson's Disease Patients
目的:探讨老年帕金森病(PD)患者血清低氧诱导因子-1α(HIF-1α)和长链非编码 RNA(LncRNA)β 分泌酶反义 RNA(BACE1-AS)表达变化与临床分期及认知功能障碍(CI)的关系.方法:选取2020 年1 月至2023 年12 月期间于本院接受治疗老年 PD 患者 90 例,作为 PD 组,根据临床分期将其分为Ⅰ期(n=25)、Ⅱ期(n=28)、Ⅲ期(n=21)、Ⅳ+Ⅴ期(n=16);根据患者认知功将其分为 CI 组(n=42)、非 CI 组(n=48);另选取90 例同期门诊健康体检者作为对照(对照组).采集老年 PD 患者入院次日、对照组患者体检当日的空腹静脉血各3～5mL,离心取血清;ELISA 试剂盒检测血清 HIF-1α 水平;qRT-PCR 检测血清 LncRNA BACE1-AS 表达;收集年龄、性别、BMI、吸烟史、饮酒史等临床基本资料,多因素 Logistic 回归分析老年 PD 患者发生 CI 的影响因素;ROC 曲线分析血清 HIF-1α、LncRNA BACE1-AS 水平对老年 PD 患者发生 CI 的预测价值.结果:与对照组相比,PD 组血清 HIF-1α、Ln-c RNA BACE1-AS 水平升高,差异有统计学意义(P<0.05).Ⅳ+Ⅴ期血清 HIF-1α、LncRNA BACE1-AS水平显著高于Ⅰ期、Ⅱ期、Ⅲ期(P<0.05);Ⅲ期血清 HIF-1α、LncRNA BACE1-AS 水平显著高于Ⅰ期、Ⅱ期(P<0.05);Ⅱ期血清 HIF-1α、LncRNA BACE1-AS 水平显著高于Ⅰ期(P<0.05).与非 CI 组相比,CI 组病程、HIF-1α、L ncRNA BACE1-AS 升高,受教育年限降低,差异有统计学意义(P<0.05).病程、HIF-1α、LncRNA BACE1-AS 是老年 PD 患者发生 CI 的影响因素(P<0.05).血清 HIF-1α、LncRNA BACE1-AS 二者联合预测老年 PD 患者发生 CI 的 AUC 为0.941,敏感性为92.86%,特异性为87.50%,优于 HIF-1α、LncRNA BACE1-AS 各自单独预测(Z 联合-HIF-1α=2.434、Z 联合-LncRNA BACE1-AS=3.045,P=0.015、0.002).结论:老年 PD 患者血清 HIF-1α、LncRNA BACE1-AS 水平升高,且与患者的临床分期、CI 相关,两者联合对老年 PD 患者发生 CI 具有较高的预测潜能.
Objective:To explore the relationship between changes in serum hypoxia inducible factor-1α(HIF-1α)and long non-coding RNA(LncRNA)β-site amyloid precursor protein cleaving enzyme 1(BACE1-AS)expression with clinical staging and cognitive impairment(CI)in elderly Parkinson's disease(PD)patients.Methods:A total of 90 elderly patients with Parkinson's disease(PD)who were treated in our hospital from January 2020 to December 2023 were selected as the PD group.They were separated into stage Ⅰ(n=25),stage Ⅱ(n=28),stage Ⅲ(n=21),and stage Ⅳ+Ⅴ(n=16)based on clinical stag-ing.According to the patient's cognitive function,they were grouped into a CI group(n=42)and a non CI group(n=48).Another 90 patients who underwent outpatient health examinations were made the control group.Fasting venous blood(3-5 mL)was collected from elderly PD patients on the second day of hospitali-zation and from control subjects during their health check-up.Serum was separated by centrifugation.Serum HIF-1α levels were measured using an ELISA kit.Serum LncRNA BACE1-AS expression was detected by quantitative real-time PCR(qRT-PCR).Clinical baseline data such as age,gender,BMI,smoking history,and alcohol consumption history were collected.Multivariate logistic regression was applied to analyze the in-fluencing factors of CI in elderly PD patients.ROC curve was applied to analyze the predictive value of serum HIF-1α and LncRNA BACE1-AS levels for CI in elderly PD patients.Results:Compared with the control group,the serum levels of HIF-1α and LncRNA BACE1-AS in the PD group were significantly higher(P<0.05).The serum levels of HIF-1α and LncRNA BACE1-AS in stage IV+V were significantly higher than those in stage Ⅰ,Ⅱ,and Ⅲ(P<0.05).The levels in stage Ⅲ were significantly higher than those in stageⅠ and Ⅱ(P<0.05).The levels in stage Ⅱ were significantly higher than those in stage I(P<0.05).Com-pared with the non-CI group,the CI group showed a significant increase in disease duration,HIF-1α,and LncRNA BACE1-AS levels,and a significant decrease in years of education(P<0.05).The course of dis-ease,HIF-1α,and LncRNA BACE1-AS were influencing factors for CI in elderly PD patients(P<0.05).The combined prediction of serum HIF-1α and LncRNA BACE1-AS for the occurrence of CI in elderly PD patients was 0.941,with a sensitivity of 92.86%and a specificity of 87.50%,which was better than the indi-vidual prediction of HIF-1α and LncRNA BACE1-AS(Z combination-HIF-1α=2.434,Z combination-LncRNA BACE1-AS=3.045,P=0.015,0.002).Conclusion:The serum levels of HIF-1α and LncRNA BACE1-AS in elderly PD patients are elevated and correlated with clinical stage and CI.The combination of the two has a high predictive potential for CI in elderly PD patients.
沈英生
福建省莆田九十五医院神经内科,福建 莆田 351100
老年帕金森病低氧诱导因子-1α长链非编码RNAβ分泌酶反义RNA临床分期认知功能障碍
Parkinson's diseaseHypoxia inducible factor-1Long non-coding RNAβ-site amyloid precursor protein cleaving enzyme 1Clinical stagingCognitive impairment
《河北医学》 2026 (6)
1011-1016,6
福建省自然科学基金资助项目(2021J01872)
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