血清多巴胺、5-羟色胺、高香草酸水平与帕金森病患者认知功能障碍的相关性分析

Correlation analysis of serum dopamine,5-hydroxytryptamine,homovanillic acid levels and cognitive dysfunction in patients with Parkinson′s disease

目的探讨血清多巴胺、5-羟色胺、高香草酸水平与帕金森病患者认知功能障碍的关系。方法选取2020年2月至2022年2月巴中市中心医院收治的118例帕金森病患者作为疾病组,另选取同期在该院体检的健康者106例作为对照组,所有研究对象均检测血清多巴胺、5-羟色胺、高香草酸水平,并采用蒙特利尔认知评估量表(MoCA)评估认知功能。根据MoCA评分将帕金森病患者分为认知功能障碍组和无认知功能障碍组,对比认知功能障碍组、无认知功能障碍组血清多巴胺、5-羟色胺、高香草酸水平,采用Pearson法分析血清多巴胺、5-羟色胺、高香草酸水平与帕金森病患者认知功能的相关性,并绘制受试者工作特征曲线分析血清多巴胺、5-羟色胺、高香草酸水平对帕金森病患者认知功能障碍的评估价值。结果疾病组血清多巴胺、5-羟色胺、高香草酸水平及MoCA评分均低于对照组,差异有统计学意义(P<0.05)。疾病组中晚期患者血清多巴胺、5-羟色胺、高香草酸水平及MoCA评分均低于早期患者,差异有统计学意义(P<0.05)。认知功能障碍组血清多巴胺、5-羟色胺、高香草酸水平均低于无认知功能障碍组,差异有统计学意义(P<0.05)。经Pearson分析结果显示,帕金森病患者血清多巴胺、5-羟色胺、高香草酸水平均与MoCA评分呈正相关(P<0.05)。血清多巴胺、5-羟色胺、高香草酸水平联合评估帕金森病患者认知功能障碍的灵敏度高于单独评估帕金森病患者认知功能障碍的灵敏度(χ^(2)=7.413,P=0.006;χ^(2)=9.714,P=0.002;χ^(2)=8.541,P=0.003),其曲线下面积(AUC)高于单独评估帕金森病患者认知功能障碍的AUC(Z=2.479,P=0.013;Z=2.271,P=0.023;Z=2.451,P=0.014)。结论不同分期帕金森病患者血清多巴胺、5-羟色胺、高香草酸水平和认知功能存在差异,血清多巴胺、5-羟色胺、高香草酸水平均与帕金森病患者认知功能关系密切,均对帕金森病患者发生认知功能障碍具有评估价值,但三者血清指标联合更有助于临床评估诊断。

Objective To explore the relationship between the levels of serum dopamine,5-hydroxytryptamine,homovanillic acid and cognitive dysfunction in patients with Parkinson′s disease.Methods A total of 118 Parkinson′s disease patients admitted to Bazhong Central Hospital from February 2020 to February 2022 were selected as the disease group,and 106 healthy patients who underwent physical examination in the hospital during the same period were selected as the control group.The levels of serum dopamine,5-hydroxytryptamine and homovanillic acid were measured in all subjects,and the cognitive function was evaluated with Montreal Cognitive Assessment Scale(MoCA).Parkinson′s disease patients were divided into cognitive impairment group and non cognitive impairment group according to MoCA score.The serum dopamine,5-hydroxytryptamine,homovanillic acid levels of the cognitive impairment group and the non cognitive impairment group were compared.Pearson correlation analysis was used to analyze the correlation between serum dopamine,5-hydroxytryptamine and homovanillic acid levels and cognitive function of Parkinson′s disease patients,and the receiver operating characteristic curve was drawn to analyze the evaluation value of serum dopamine,5-hydroxytryptamine and homovanillic acid levels on cognitive dysfunction of Parkinson′s disease patients.Results The levels of serum dopamine,5-hydroxytryptamine,homovanillic acid and MoCA score in the disease group were lower than those in the control group,with statistical significance(P<0.05).The levels of serum dopamine,5-hydroxytryptamine,homovanillic acid and MoCA score in advanced patients were lower than those in early patients,and the difference was statistically significant(P<0.05).The levels of serum dopamine,serotonin and homovanillic acid in the cognitive dysfunction group were lower than those in the non-cognitive dysfunction group,and the difference was statistically significant(P<0.05).The results of Pearson analysis showed that the levels of serum dopamine,5-hydroxytryptamine and homovanillic acid in Parkinson′s disease patients were positively correlated with MoCA score(P<0.05).The sensitivity of the combined assessment of serum dopamine,serotonin and homovanillic acid in Parkinson′s disease patients was higher than that in Parkinson′s disease patients alone(χ^(2)=7.413,P=0.006;χ^(2)=9.714,P=0.002;χ^(2)=8.541,P=0.003),the area under the curve(AUC)was higher than the AUC for assessing cognitive impairment in Parkinson′s disease alone(Z=2.479,P=0.013;Z=2.271,P=0.023;Z=2.451,P=0.014).Conclusion There are differences in serum levels of dopamine,5-hydroxytryptamine,homovanillic acid and cognitive function among different stages of Parkinson′s disease patients.Serum levels of dopamine,5-hydroxytryptamine,and homovanillic acid are closely related to cognitive function in Parkinson′s disease patients,all of which have evaluation value for the occurrence of cognitive dysfunction in Parkinson′s disease patients.However,the combination of the three serum indicators is more helpful for clinical evaluation and diagnosis.