探讨ApoA-1、同型半胱氨酸、Cys-C与帕金森病认知功能的关系

Exploring the Relationship Between ApoA-1, Homocysteine, Cys-C and Cognitive Function in Parkinson’s Disease

目的 探讨ApoA-1、同型半胱氨酸、Cys-C与帕金森病认知功能之间的关系。方法 选取2020年1月—2021年12月于泰州市第二人民医院神经内科就诊的帕金森病患者60例为研究对象,根据患者认知功能状态分为认知正常组和认知障碍组,各30例,选取同一时间健康体检人员30名为对照组。评价3组认知功能,检测ApoA-1、同型半胱氨酸、Cys-C水平,并分析帕金森综合征认知功能障碍与ApoA-1、同型半胱氨酸、Cys-C的相关性,分析帕金森综合征患者认知功能障碍的影响因素。结果 认知正常组患者和认知障碍组患者UPDRS评分为(13.20±2.21)分、(18.02±2.05)分,均高于对照组,MMSE为(22.28±2.13)分、(17.85±2.11)分,MoCA评分为(21.30±2.18)分、(16.35±2.16)分,均低于对照组,差异有统计学意义(P<0.05);认知正常组、认知障碍组患者ApoA-1水平为(1.78±0.29)、(1.27±0.27)g/L,均低于对照组,同型半胱氨酸为(18.70±4.59)、(30.18±5.98)μmol/L,Cys-C水平为(4.20±0.81)、(5.98±0.69)mg/L,均高于对照组,差异有统计学意义(t=5.455、10.711、10.716、18.524、4.948、16.969,P<0.05)。二元回归和线性相关性分析,UPDRS评分≥5分,MMSE评分<27分,MoCA评分<26分、ApoA-1水平低、同型半胱氨酸水平高、Cys-C水平高为帕金森综合征患者发生认知功能障碍的危险因素(P<0.001);帕金森综合征患者MMSE评分与ApoA-1水平呈正相关、与同型半胱氨酸水平呈负相关,与Cys-C水平呈负相关(P<0.001)。结论 ApoA-1、同型半胱氨酸、Cys-C与帕金森病患者认知功能之间的关系密切,可预估帕金森病者认知功能。

Objective To investigate the relationship between ApoA-1, homocysteine, Cys-C and cognitive function in Parkinson’s disease. Methods 60 patients with Parkinson’s disease admitted to the Department of Neurology of Taizhou Second People’s Hospital from January 2020 to December 2021 selected as the research objects, according to the patients’ cognitive function status, they were divided into the cognitively normal group and the cognitively impaired group, 30 cases in each group, and 30 people in the health examiners at the same time were the control group. The cognitive functions of the three groups were evaluated, and ApoA-1, homocysteine, and Cys-C were detected. The correlation between cognitive dysfunction of PD and ApoA-1, homocysteine and Cys-C was analyzed, and the influencing factors of cognitive dysfunction in PD patients were analyzed. Results UPDRS scores of(13.20±2.21) points and(18.02±2.05) points in cognitive normal group and cognitive impairment group were higher than those in control group,the MMSE scores of(22.28±2.13) points and(17.85±2.11) points and MoCA scores of(21.30±2.18) points and(16.35±2.16) points were lower than those of the control group, and the difference was statistically significant(P<0.05). The levels of ApoA-1 in the cognitively normal group and the cognitively impaired group were(1.78±0.29) g/L and(1.27±0.27) g/L, which were lower than those in the control group, homocysteine levels of(18.70±4.59) μmol/L and(30.18±5.98) μmol/L and Cys-C levels of(4.20±0.81) mg/L and(5.98±0.69) mg/L were higher than those of control group, the difference was statistically significant(t=5.455, 10.711, 10.716, 18.524, 4.948, 16.969, P<0.05). By binary regression and linear correlation analysis, UPDRS score ≥5 points, MMSE score <27 points, MoCA score <26 points, low level of ApoA-1, high level of homocysteine and high level of Cys-C were risk factors for cognitive dysfunction in PD patients(P<0.001);MMSE score of PD patients was positively correlated with ApoA-1 level, negatively correlated with homocysteine level and negatively correlated with Cys-C level(P<0.001). Conclusion ApoA-1, homocysteine, and Cys-C are closely related to cognitive function in Parkinson’s disease and can predict cognitive function in Parkinson’s disease patients.