老年帕金森病患者血清铜蓝蛋白水平与冲动性增高的相关性

Correlation between serum ceruloplasmin level and elevated impulsivity in elderly patients with Parkinson′s disease

目的探讨老年帕金森病(PD)患者血清铜蓝蛋白水平与冲动性增高的相关性。方法选择2019年10月至2021年6月在金华市人民医院就诊的227例老年PD患者作为研究对象,根据血清铜蓝蛋白水平的第75百分位值(P_(75))进行分组,血清铜蓝蛋白水平<P_(75)的归为正常组,≥P_(75)的归为高水平组。观察2组患者冲动性量表第十一版(BIS-11)二阶和一阶因子得分差异,在平衡一般特征、帕金森病评定量表(MDS-UPDRS)第三部分、Hoehn&Yahr量表、Addenbrooke认知检查修正版(ACE-R)、临床治疗方案等资料后,观察铜蓝蛋白与BIS-11的相关性。结果共56例患者纳入高水平组,171例患者纳入正常组。高水平组患者铜蓝蛋白水平、女性患者比例及MDS-UPDRSⅢ、Hoehn&Yahr量表、ACE-R评分均高于正常组患者,差异均有统计学意义(均P<0.05)。高水平组二阶非计划及对应的一阶自我控制、一阶自知复杂度高于正常组患者,差异均有统计学意义(均P<0.05);两组患者二阶注意、一阶注意、一阶认知不稳定性、二阶动机、一阶动机、一阶稳定性和BIS-11总分相比较差异均无统计学意义(均P>0.05)。采用多因素logistic分析去除混杂因素后,铜蓝蛋白与二阶非计划及其对应的一阶因子(自我控制和自知复杂度)存在相关性(均P<0.05)。结论老年PD患者血清铜蓝蛋白水平与BIS-11非计划性冲动水平升高有关。

Objective To investigate the correlation between serum ceruloplasmin level and elevated impulsivity in elderly patients with Parkinson′s disease(PD).Methods 227 elderly PD patients treated in Jinhua People′s Hospital from October 2019 to June 2021 were selected as the research objects.They were grouped according to the 75th percentile of serum ceruloplasmin.0-75th percentile was defined as normal and>75th percentile was defined as high level.The differences of second-order and first-order factor scores of Barratt′s Impulsivity Scale Version 11(BIS-11)between the two groups were observed.After balancing the general characteristics,the third part of Parkinson′s Disease Rating Scale(MDS-UPDRS),Hoehn&Yahr Scale,Addenbrooke Cognitive Examination Revised Edition(ACE-R),clinical treatment plan and other data,the correlation between ceruloplasmin and BIS-11 was observed.Results According to the 75th percentile level of ceruloplasmin,56 patients were included in the high-level group and 171 patients were included in the normal group.The level of ceruloplasmin,the ratio of female patients,MDS-UPDRSⅢ,Hoehn&Yahr Scale and ACE-R score in the high-level group were significantly higher than those in the normal group(all P<0.05).The second-order unplanned and corresponding first-order self-control and first-order self-knowledge complexity in the high-level group were higher than those in the normal group(all P<0.05).There was no significant difference in second-order attention,first-order attention,first-order cognitive instability,second-order motivation,first-order motivation,first-order stability and BIS-11 score between the two groups(all P>0.05).After removing the confounding factors by multifactor logistic analysis,ceruloplasmin was correlated with second-order unplanned and its corresponding first-order factors(self-control and self-knowledge complexity)(all P<0.05).Conclusions The serum ceruloplasmin level in elderly PD patients is related to the elevated level of BIS-11 unplanned impulse.