帕金森病伴认知障碍患者血尿酸的变化及相关因素分析

Level of blood uric acid in Parkinson disease complicated with cognitive impairment and related factors analysis

目的:探讨帕金森病伴认知障碍与患者血尿酸变化的关系,分析影响帕金森病伴认知障碍的相关因素。方法:选择2014年1月至2016年12月诊治的60例帕金森病患者,使用蒙特利尔认知评估量表(MoCA)评估患者的认知障碍程度,并进行Hoehn&Yahr帕金森病严重度分级(H-Y)。对患者年龄、性别、病程、受教育程度等资料进行逐步多因素回归分析,探讨患者发生认知障碍的相关因素;检测患者的血尿酸、尿微量白蛋白等水平,并与健康人(60例)对比,分析帕金森病伴认知障碍与血尿酸变化的关系。结果:帕金森病组血尿酸平均水平为(258.0±55.6)μmol/L,低于健康组[(328.6±50.8)μmol/L],差异有统计学意义(P<0.05)。帕金森病组与健康组及帕金森病不同分期患者的尿微量白蛋白水平差异无统计学意义。早期帕金森病患者血尿酸水平与中晚期帕金森病患者差异无统计学意义。合并认知障碍的帕金森病患者血尿酸平均水平为(235.6±65.3)μmol/L,明显低于未合并认知障碍者[(272.3±60.3)μmol/L],差异有统计学意义(P<0.05)。帕金森病患者MoCA评分与其血尿酸水平、受教育年限正相关,与患者的病程、H-Y分级负相关。结论:血尿酸可能参与帕金森病患者认知障碍的发生,对血尿酸水平进行干预有助于延缓患者的病程。

Objective:To explore the relationship between cognitive dysfunction and blood acid changes in patients with Parkinson disease,and to analyze the influence factors of cognitive dysfunction.Methods:Totally sixty patients with Parkinson disease in our hospital from January 2014 to December 2016 were enrolled.The cognitive impairment was assessed using Montreal Cognitive Assessment Scale(MoCA)and the patients was graded using Hoehn&Yahr Parkinson disease severity(H-Y).The age,sex,gender,course of disease and education level were retrospectively analyzed to explore the relevant factors of cognitive dysfunction.The levels of serum uric acid and urine microalbumin were detected and compared with healthy subjects(60 cases),and the relationship of blood uric acid and cognitive impairment was analyzed.Results:The level of serum uric acid in Parkinson disease group was(258.0±55.6)μmol/L,being significantly lower than that in healthy group([328.6±50.8]μmol/L),while the level of urine microalbumin was not significantly different between two groups.No significant difference was found between patients in early stage and advanced stage.In patients with cognitive dysfunction,the level of serum uric acid was(235.6±65.3)μmol/L,being significantly lower than that in patients without cognitive impairment([272.3±60.3]μmol/L,P<0.05).MoCA score of Parkinson patients was positively correlated with level of serum uric acid and duration of education,and was negatively correlated with course of disease and H-Y grade.Conclusions:Uric acid in serum may be involved in pathogenesis of cognitive impairment in Parkinson disease.Intervention of serum uric acid level is helpful to delay the course of disease.