帕金森病的血红蛋白变化特点和经颅超声特征

The characteristics of hemoglobin change and transcranial ultrasonography in Parkinson's disease

目的探讨PD患者的血红蛋白变化特点和经颅超声特征,寻找辅助诊断PD的生物学标志物。方法纳入2017年1月-2018年1月就诊于郑州大学第五附属医院神经内科临床诊断为原发性PD患者38例(男18例,女20例)和同期就诊的健康者42例(男19例,女23例),进行Hoehn&Yahr分级,收集他们的血红蛋白结果,并行经颅超声检查、测量黑质强回声≥Ⅲ级的区域面积。分析血红蛋白、黑质强回声面积的特点及其与Hoehn&Yahr分级的关系。结果 38例患者中PD患者中黑质强回声≥Ⅲ级者28例,42例健康者中黑质强回声≥Ⅲ级者3例。PD组的血红蛋白水平、铁蛋白均低于健康对照组,差异有统计学意义(t=-2. 514,P=0. 014; t=-3. 669,P <0. 001)。Spearman相关性分析显示血红蛋白与Hoehn&Yahr分级存在负相关(r=-0. 477,P=0. 02),黑质强回声面积与Hoehn&Yahr分级存在正相关(r=0. 469,P=0. 003)。结论 PD患者血红蛋白水平降低,黑质强回声增强,并且和疾病的严重程度相关,对PD的诊断具有一定的应用价值。

Objective Exploring the characteristics of hemoglobin and the changes of TCS in patients with Parkinson’s disease(PD)in order to find biological markers for assisting in the diagnosis of PD.Methods 38 patients(18 males and 20 females)diagnosed with primary Parkinson’s disease and 42 matched healthy controls(19 males and 23 females)were included in the department of neurology of the fifth affiliated hospital of Zhengzhou university from January 2017 to January 2018.Hoehn&Yahr grading and the transcranial ultrasonography was performed.When SN strong echo more than gradeⅢ,the substantia nigra(SN)echo area and midbrain echo area were measured.Analyze the characteristics of hemoglobin and the strong echo area of SN.Analyze the features of hemoglobin and the strong echo area of SN and Hoehn&Yahr grading.The relationship between hemoglobin/the strong echo area of SN and Hoehn&Yahr grading was also calculated and statistically analyzed.Results 28 patients with gradeⅢstrong echo or more than gradeⅢwere found in the 38 patients with PD.And 3 patients with gradeⅢstrong echo or more than gradeⅢin 42 healthy individuals.The hemoglobin level and ferritin in the PD group were lower than those in the healthy control group(t=-2.514,P=0.014;t=-3.669,P<0.001).Spearman correlation analysis showed that there was a negative correlation between hemoglobin and Hoehn&Yahr grading(r=-0.477,P=0.02),and there was a positive correlation between the strong echo area of the SN and Hoehn&Yahr grading(r=0.469,P=0.003).Conclusion The level of hemoglobin in PD patients is decreased,and the strong echo of the SN changes.Which is related to the severity of the disease.This has a certain application value for the diagnosis of PD.