帕金森病血钙水平与认知功能相关性分析

Correlation analysis of serum calcium level and cognition in the patients with Parkinson＇s disease

目的探讨帕金森病（PD）患者血钙水平与认知功能的关系，对认知功能相关因素进行分析，评估血钙水平与具体认知功能域的相关性。方法选择2013年12月至2015年5月在苏州大学附属第二医院住院的77例PD患者及同时期75名健康对照者，检测空腹血钙水平，对PD患者进行认知功能、运动功能和抑郁评分，分为痴呆组和非痴呆组，对PD患者血钙、认知功能相关因素进行比较及分析。结果（1）PD痴呆组血钙水平[（2．21±0．09）mmol／L]较健康对照组血钙水平[（2．30±0．09）mmol／L]明显降低（P〈0．001），PD非痴呆组血钙水平[（2．27±0．13）mmol／L]与健康对照组血钙水平无明显差异（P=0．144），PD痴呆组的血钙水平低于PD非痴呆组，差异有统计学意义（P=0．023）。（2）PD患者的认知功能与教育水平、血钙水平、H—Y分期、UPDRS Ⅲ有相关性（P〈0．05），与性别、年龄、病程、抑郁程度、体质指数（BMI）、总左旋多巴等效剂量无相关性（P〉0．05）。（3）PD患者血钙水平与视空间和执行能力、计算力、语言能力均有相关性（P1=0．004；P2=0．027；P3=0．021）。结论（1）PD患者认知功能障碍与血钙水平降低有关，血钙水平越低，认知功能水平越低。（2）PD患者的教育水平、H—Y分期和UPDRS Ⅲ评分影响认知功能的改变。（3）PD患者血钙水平主要与患者视空间和执行能力、计算力、语言能力的认知功能域密切相关。

Objective To investigate the relation between cognition and serum calcium in the patients with Parkinson＇s disease （PD） , analyze the related factors of cognition, and evaluate the correlation of serum calcium with specific cognitive domains. Methods A total of 77 patients with Parkinson＇s disease who was hospitalized in the Second Affiliated Hospital of Sooehow University, from Dee 2013 to May 2015 were subjected to the cognitive, motor and depression function assessment, and the fasting blood calcium samples were collected from the PD patients and 75 normal control subjects. According to cognitive function, PD patients were divided into dementia group and without dementia group. Then the serum calcium levels of three groups and the related factors of the cognitive were analyzed by multiple linear regression. Results （1） The level of serum calcium in PD group with dementia （2.21 ± 0.09） mmol/L was significantly lower than the normal control group （2.30 ± 0.09） mmol/L （ P 〈 0.001 ）, and there was no difference between the level of serum calcium in PD group without dementia （2.27 ± 0.13 mmol/L） and normal control group （P = 0. 144）. The level of serum calcium in PD group with dementia was lower than PD group without dementia, and there was marked statistical significance （P = 0. 023 ）. （2） In PD patients, the cognitive scores correlated with serum calcium levels, education, H-Y stages and Unified Parkinson＇s Disease Rating Scale （UPDRS） Ⅲ scores （P 〈0.05 ）, but didn＇t with gender, age, disease duration, depression levels, Body Mass Index （BMI） and total equivalent levodopa doses （P 〉0.05）. （3） In PD patients, serum calcium level correlated with the visuospatial and executive capability, calculation ability, language ability （P1 = 0. 004 ; P2 = 0. 027 ; P3 = 0. 021 ）. Conclusions （ 1 ） There is correlation between the serum calcium and the cognitive impairment. Lower serum calcium level predicts worse cognitive scores. （2） In PD patients, the change of the cognitive function is affected by their education, H-Y stages and UPDRS Ⅲ scores. （ 3 ） The serum calcium level of PD patients closely relates to the cognitive domain of the visuospatial and executive capability, calculation ability, and language ability.