血管紧张素及其转化酶与帕金森病患者认知障碍与运动障碍的关系
作者:
作者单位:

1.南京医科大学护理学院,江苏 南京 211166 ; 2.江阴市人民医院神经内科,江苏 无锡 214432

中图分类号:

R742.5;R749.1

基金项目:

江苏省卫生健康委员会研究课题(Z2020028);教育部人文社会科学研究青年基金项目(22YJCZH089)


Correlation between angiotensin with its converting enzyme and disorders of cognition and motor in patients with Parkinson’s disease
Author:
Affiliation:

1.School of Nursing,Nanjing Medical University,Nanjing 211166 ; 2.Department of Neurology,Jiangyin People’sHospital,Wuxi 214432 ,China

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    摘要:

    目的:探讨血管紧张素[包括血管紧张素(angiotensin,Ang)Ⅰ、AngⅡ、Ang1-7]及其转化酶[血管紧张素转化酶 (angiotensin converting enzyme,ACE)、ACE2]与帕金森病(Parkinson’s disease,PD)认知障碍及运动障碍之间的关联。方法:收集2023 年 9 月 1 日—2024 年 6 月 1 日在江阴市人民医院诊断为 PD 的患者 200 例,通过采集病史、利用蒙特利尔认知评估 (Montreal cognitive assessment,MoCA)、简易智力状态检查(mini-mental state examination,MMSE)等量表以及国际运动障碍协会 PD评分量表等,对患者进行认知功能和运动功能的评估。使用酶联免疫吸附实验检测患者血清样本的ACE、ACE2、AngⅠ、 AngⅡ、Ang1-7等指标水平,并利用随机森林模型进行PD认知及运动障碍的预测分析。结果:基于ACE、AngⅠ、AngⅡ、Ang1-7 及年龄等指标构建的PD认知障碍预测模型在验证集上的准确度为0.847,受试者工作特征曲线下面积(area under curve,AUC) 为0.909。基于ACE、AngⅠ和Ang1-7构建的PD运动障碍预测模型在验证集上的AUC为0.618。不论是否伴有认知障碍,早期与晚期运动障碍患者的ACE、AngⅠ、AngⅡ和Ang1-7水平差异均有统计学意义。结论:ACE和AngⅠ,在PD认知和运动障碍中的差异性表明其在PD病程进展中可能扮演关键角色。随机森林模型在预测PD认知障碍方面表现良好,有助于早期识别认知功能障碍的PD患者。

    Abstract:

    Objective:To investigate the correlation between angiotensin[including angiotensin(Ang)Ⅰ,Ang Ⅱ and Ang 1-7]with its converting enzyme[including angiotensin converting enzyme(ACE)and ACE2]and cognitive and motor impairments in Parkinson’s disease(PD). Methods:Two hurdred patients diagnosed with PD at Jiangyin People’s Hospital between september 1,2023 and June 1, 2024 were included. We evaluated cognitive and motor functions of patients by collecting medical history,assessed cognitive function by using Montreal cognitive assessment(MoCA),mini - mental state examination(MMSE)and other scales,and assessed motor symptoms by using the International Movement Disorders Association Parkinson’s Disease Score scale. Serum samples were collected. ACE,ACE2,AngⅠ,AngⅡ,Ang1 - 7 and other indicators were detected by enzyme linked immunosorbent assay method,and PD cognitive and motor disorders were predicted by a random forest model. Results:The predictive model of PD cognitive impairment was constructed based on ACE,AngⅠ,AngⅡ,Ang1-7 and age,and the accuracy of the validation set was 0.847,the area under receiver operating characteristic curve(AUC)was 0.909. Based on the ACE,AngⅠ and Ang1-7,the prediction model of PD dyskinesia was built,and the AUC value of validation set was 0.618. Patients with early versus late dyskinesia showed statistically significant differences in ACE,AngⅠ,AngⅡ,and Ang1-7 levels regardless of the presence or absence of cognitive impairment. Conclusion:The differences of ACE and Ang Ⅰlevels in PD cognitive and motor disorders suggest that those indicators may play key roles in the progression of PD disease. The random forest model performed well in predicting PD cognitive impairment and was helpful in early identification of PD patients with cognitive dysfunction.

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钱青,王庆广,李现文.血管紧张素及其转化酶与帕金森病患者认知障碍与运动障碍的关系[J].南京医科大学学报(自然科学版),2025,(2):218-226

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  • 收稿日期:2024-07-06
  • 在线发布日期: 2025-02-19
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