血清生化指标对血管性帕金森综合征患者的辅助诊断价值

Value of serum biochemical parameters in accessory diagnosis of vascular Parkinson’s syndrome patients

目的探讨血清生化指标对血管性帕金森综合征(VP)的辅助诊断价值。方法选择我院就诊的VP患者62例(VP组)和帕金森病(PD)患者57例(PD组),另选择同期就诊的健康体检者35例(对照组)。收集3组的一般临床资料及血清生化指标。采用ROC曲线判别各项指标对VP的辅助诊断效能,计算ROC曲线下面积(AUC)。结果 3组年龄、性别、同型半胱氨酸(Hcy)、叶酸、糖化血红蛋白、TC、HDL-C、LDL-C水平比较,差异有统计学意义(P<0.05,P<0.01)。与对照组比较,VP组年龄、男性、Hcy水平明显升高,HDL-C水平明显降低,VP组和PD组叶酸、TC、LDL-C水平明显降低(P<0.05,P<0.01)。Logistic回归分析显示,年龄和Hcy升高是VP危险因素,HDL-C升高是VP保护因素(P<0.05,P<0.01)。Spearman相关性分析显示,VP患者叶酸与糖化血红蛋白、TC、LDL-C水平呈正相关(r=0.997,r=0.992,r=0.993,P<0.01),糖化血红蛋白与TC、LDL-C水平呈正相关(r=0.997,r=0.998,P<0.01)。Hcy与叶酸、糖化血红蛋白、尿酸水平呈负相关(P<0.05)。Hcy判别VP的AUC为0.902(95%CI:0.832~0.982,P=0.000),叶酸+HDL-C+LDL-C+TC的AUC为0.828(95%CI:0.739~0.917,P=0.000)。结论 Hcy、叶酸联合血脂水平可能是VP的潜在辅助诊断指标。

Objective To study the value of serum biochemical parameters in accessory diagnosis of vascular Parkinsonism(VP) patients.Methods Sixty-two VP patients and 57 PD patients admitted to our hospital served as VP group and PD group respectively with 35 subjects undergoing physical examination served as a control group.Their general clinical data and serum biochemical parameters were recorded.The value of serum biochemical parameters in accessory diagnosis of VP was analyzed by ROC curve analysis.The AUC for serum biochemical parameters in accessory diagnosis of VP was measured by ROC curve analysis.Results The age,gender,serum levels of Hcy,folic acid,HbA1 c,TC,HDL-C and LDL-C were significantly different in 3 groups(P<0.05,P<0.01).The age was significantly older,the number of males was significantly greater,the serum level of Hcy was significantly higher while that of HDL-C was significantly lower in VP group than in control group,and the serum levels of folic acid,TC,LDL-C were significantly lower in VP group and PD group than in control group(P<0.05,P<0.01).Logistic regression analysis showed that age and elevated serum Hcy level were the risk factors for VP while elevated serum HDL-C level was the protective factor for VP(P<0.05,P<0.01).Spearman correlation analysis displayed that the serum levels of folic acid were positively related with those of HbA1 c,TC and LDL-C(r=0.997,r=0.992,r=0.993,P<0.01) while the serum levels of hemoglobin were negatively related with those of TC and LDL-C(r=0.997,r=0.998,P<0.01),and the serum levels of Hcy were negatively related with those of folic acid,HbA1 c and UA(P<0.05).The AUC for Hcy and folic acid+HDL-C+LDL-C+TC in idenfication of VP was 0.902(95%CI:0.832-0.982,P=0.000) and 0.828(95%CI:0.739-0.917,P=0.000) respectively.Conclusion Serum Hcy and folic acid levels combined with blood lipid level can be used as an accessory diagnostic marker of VP.