帕金森病人血清胱抑素C水平、尿酸变化与病情分期、认知障碍、运动功能的相关性研究

马婷婷; 胡鸿炜; 林慧怡; 张应魏

doi:10.13898/j.cnki.issn.1000-2200.2022.08.013

帕金森病人血清胱抑素C水平、尿酸变化与病情分期、认知障碍、运动功能的相关性研究

Correlation study of serum cystatin C level, uric acid change with disease stage, cognitive impairment, motor function in Parkinson′s disease patients

摘要

摘要:
目的探讨帕金森病(PD)病人血清胱抑素C(CysC)、尿酸(UA)水平变化与病情分期、认知障碍、运动功能的相关性。
方法纳入PD病人90例作为PD组，选取同期健康体检者82名作为健康组。比较2组血清CysC与UA水平，根据帕金森Hoehn-Yahr(H-Y)分期将PD病人分成H-Y≥3期组(n=36)、H-Y < 3期组(n=54)。根据蒙特利尔认知评估量表(MoCA)将PD病人分成认知障碍组(n=49，MoCA < 26分)、非认知障碍组(n=41，MoCA≥26分)。根据统一帕金森病评估量表第三部分(UPDRS-Ⅲ)评估PD病人运动障碍程度，并分成轻度组(n=26，0~15分)、中度组(n=41，16~40分)、重度组(n=23，41~56分)。比较不同病情分期、认知障碍、运动功能病人的血清CysC与UA水平，经Pearson线性相关分析血清CysC、UA水平与H-Y分期、MoCA评分、UPDRS-Ⅲ评分的相关性。
结果PD组血清CysC高于健康组，但血清UA水平低于健康组(P < 0.01)。H-Y≥3期组血清CysC、H-Y分期较H-Y < 3期组增高，血清UA较H-Y < 3期组降低(P < 0.01)。认知障碍组血清CysC较非认知障碍组增高，血清UA、MoCA评分较非认知障碍组降低(P < 0.01)。重度组血清CysC及UPDRS-Ⅲ评分较中、轻度组增高，且中度组高于轻度组，但重度组血清UA较中、轻度组降低，且中度组低于轻度组(P < 0.01)。Pearson线性相关分析结果显示，PD病人血清CysC与H-Y分期、UPDRS-Ⅲ评分呈正相关，与MoCA评分呈负相关(P < 0.05~P < 0.01)，而血清UA与H-Y分期、UPDRS-Ⅲ评分呈负相关，与MoCA评分呈正相关(P < 0.05~P < 0.01)。
结论PD病人血清CysC水平增高，而血清UA降低，且二者均与病人的病情分期、认知障碍、运动功能存在相关性，临床可将血清CysC、UA作为评估PD进展的指标。

Abstract:
ObjectiveTo explore the relationship between the changes in serum cystatin C(CysC) and uric acid(UA) in Parkinson′s disease(PD) patients with disease stage, cognitive impairment, and motor function.
MethodsA total of 90 PD patients were selected as the PD group, and 82 healthy people who received physical examination during the same period were selected as the healthy group.Levels of serum CysC and UA were compared between the two groups.PD patients were divided into H-Y≥3 stage group(n=36) and H-Y < 3 stage group(n=54) according to Parkinson′s Hoehn-Yahr(H-Y) staging.According to the Montreal cognitive assessment scale(MoCA), PD patients were divided into cognitive impairment group(n=49, MoCA < 26 points) and non-cognitive impairment group(n=41, MoCA≥26 points).According to the third part of the unified parkinson′s disease assessment scale(UPDRS-Ⅲ), the degree of dyskinesia of PD patients was evaluated, and they were divided into the mild group(n=26, 0-15 points), moderate group(n=41, 16-40 Points), and severe group(n=23, 41-56 points).The serum CysC and UA in patients with different disease stages, cognitive impairment, and motor function were compared.The correlation among the serum CysC and UA levels, H-Y staging, MoCA score and UPDRS-Ⅲ score was analyzed by Pearson linear correlation.
ResultsThe serum CysC in PD group was higher than that in healthy group, but the level of serum UA was lower than that in healthy group(P < 0.01).Serum CysC and H-Y staging of H-Y≥3 stage group were higher than H-Y < 3 stage group, and serum UA was lower than H-Y < 3 stage group(P < 0.01).The serum CysC of the cognitive impairment group was higher than that in the non-cognitive impairment group, and the serum UA and MoCA score were lower than that in the non-cognitive impairment group(P < 0.01).Serum CysC and UPDRS-Ⅲ scores of the severe group were higher than those in the moderate and mild groups, and the moderate group was higher than the mild group, but the severe group had a lower serum UA than the moderate and mild groups, and the moderate group was lower than the mild group(P < 0.01).The results of Pearson linear correlation analysis showed that serum CysC in PD patients was positively correlated with HY staging and UPDRS-Ⅲ score, and negatively correlated with MoCA score(P < 0.05 to P < 0.01), while serum UA was negatively correlated with HY staging and UPDRS-Ⅲ score, and positively correlated with MoCA score(P < 0.05 to P < 0.01).
ConclusionsSerum CysC level in PD patients is increased, while serum UA is decreased, and both of them are related to the patient′s disease stage, cognitive impairment and motor function.Serum CysC and UA can be used clinically as indicators to evaluate the PD progression.

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