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研究
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1.江阴市人民医院;2.南京医科大学

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Relationship between angiotensin and its converting enzyme and cognitive and motor disorders in patients with Parkinson's disease
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    摘要:

    目的 探讨血管紧张素(包括血管紧张素Ⅰ(Angiotensin Ⅰ, AngⅠ)、血管紧张素Ⅱ(Angiotensin Ⅱ, AngⅡ)、血管紧张素1-7(Angiotensin 1-7, Ang1-7))及其转化酶(血管紧张素转化酶(Angiotensin converting enzyme, ACE)、血管紧张素转化酶2(Angiotensin converting enzyme 2, 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 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帕金森病评分量表等,对收集到的200名患者进行了认知功能和运动功能的评估。使用酶联免疫吸附剂测定(enzyme linked immunosorbent assay, ELISA)方法检测患者血清样本的ACE、ACE2、AngI、AngII、Ang(1-7)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,ROC曲线下与坐标轴围成的面积(Area Under Curve, AUC)值为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值为0.618。不论是否伴有认知障碍,早期与晚期运动障碍患者在ACE、AngI、AngII和Ang1-7水平上均表现出显著的统计学差异。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。未来应进一步研究其他肾素-血管紧张素系统的活性产物作为PD生物标志物和治疗靶点的潜力,以提供更全面的治疗策略。

    Abstract:

    Objective To investigate the association between angiotensin (including angiotensin Ⅰ, angiotensin Ⅱ and angiotensin 1-7) and its converting enzyme (including angiotensin converting enzyme and angiotensin converting enzyme 2) and cognitive and motor impairments in Parkinson's Disease (PD). Methods The 200 patients' cognitive and motor functions were evaluated by collecting medical history, using Montreal cognitive assessment (MoCA), Mini-mental State Examination (MMSE) and other scales to assess cognitive function, and using the International Movement Disorders Association Parkinson's Disease Score scale to assess motor symptoms. Serum samples were collected, ACE, ACE2, AngI, AngII, Ang(1-7) and other indicators were detected by enzyme linked immunosorbent assay (ELISA) method, and PD cognitive and motor disorders were predicted by random forest model. Results Based on ACE, AngI, AngII, Ang1-7 and age, the predictive model of PD cognitive impairment on the accuracy of the validation set is 0.847, under ROC Curve and the coordinate axis of Area (AUC) value is 0.909. Based on the ACE, AngI and prediction model of PD dyskinesia Ang1-7 building on the validation set the AUC value is 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 difference of renin-angiotensin system, especially ACE and AngI, in PD cognitive and motor disorders suggests that it may play a key role 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. The potential of RAS components as PD biomarkers and therapeutic targets should be further investigated in the future to provide more comprehensive treatment strategies.

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  • 收稿日期:2024-07-06
  • 最后修改日期:2024-09-14
  • 录用日期:2024-12-30
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