经颅超声检查帕金森病黑质强回声与铁代谢的相关性

Correlation Between Hyperechogenic Substantia Nigra and Iron Metabolism in Parkinson's Disease

目的探讨帕金森病(PD)患者特异性的黑质强回声改变与血清铁代谢相关参数的相关性。资料与方法纳入107例PD患者,根据经颅超声检查(TCS)中黑质回声改变,将PD患者分为黑质强回声(HSN)组57例和黑质回声正常(NSN)组50例,同时纳入49名正常人为对照组。分析3组铁代谢参数的差异及代谢参数与HSN的相关性。结果HSN组血浆铜蓝蛋白[0.21(0.18,0.25)g/L]和NSN组血浆铜蓝蛋白[0.24(0.20,0.29)g/L]均低于对照组[0.31(0.26,0.37)g/L](F=41.735,P<0.01)。HSN组铜蓝蛋白水平低于正常范围的患者比例高于NSN组[51%(29/57)比26%(13/50),χ^(2)=6.025,P=0.014]。HSN、NSN、对照组转铁蛋白水平分别为(2.22±0.38)g/L、(2.14±0.45)g/L、(2.67±0.54)g/L,3组比较差异有统计学意义(F=27.392,P均<0.001)。转铁蛋白水平与HSN面积呈负相关(r=-0.454,P<0.01)。结论铜蓝蛋白水平降低可能是导致PD患者出现HSN的因素,HSN面积与转铁蛋白水平呈负相关。

Purpose To investigate the correlation between hyperechogenic substantia nigra(HSN)in Parkinson's disease(PD)patients and serum iron metabolism parameters.Materials and Methods This study enrolled 107 PD patients.According to the echo of substantia nigra in transcranial sonography(TCS),PD patients were divided into the HSN group(57 cases)and the normal substantia nigra(NSN)group(50 cases).Meanwhile,49 normal people were included as the control group.The differences in iron metabolism parameters between the three groups,and the correlation between iron metabolism parameters and HSN were analyzed.Results The ceruloplasmin in the HSN group[0.21(0.18,0.25)g/L]and NSN group[0.24(0.20,0.29)g/L]were lower than those in the control group[0.31(0.26,0.37)g/L](F=41.735,P<0.01).The proportion of patients with ceruloplasmin levels below the normal range in the HSN group was higher than that in the NSN group[51%(29/57)vs.26%(13/50),χ^(2)=6.025,P=0.014].The transferrin levels of HSN,NSN,and control group were(2.22±0.38)g/L,(2.14±0.45)g/L and(2.67±0.54)g/L,respectively.The differences among the three groups were statistically significant(F=27.392,P<0.001).Moreover,there was a negative correlation between transferrin level and HSN area(r=-0.454,P<0.01).Conclusion Decreased ceruloplasmin level may be a factor leading to HSN in PD patients,and HSN area is negatively correlated with transferrin level.