PD患者全身免疫炎症指数和免疫球蛋白水平与运动并发症的关联性分析

Correlation analysis of systemic immune inflammatory index and immunoglobulin levels with exercise complications in Parkinson's disease(PD)patients

目的研究帕金森(Parkinson's disease,PD)患者全身免疫炎症指数和免疫球蛋白水平与运动并发症的关联性。方法以2022年1月-2023年6月新疆医科大学第二附属医院神经内科确诊PD住院患者218例为研究对象,根据患者临床症状是否发生症状波动和异动症分为有运动并发症组和无运动并发症组。收集两组患者一般资料,采用SYSMEX XN-3000全自动分析仪检测两组血常规并计算中性粒细胞计数/淋巴细胞比值(Neutrophil-lymphocyte ratio,NLR)、全身免疫炎症指数(Systemic immune-inflammation index,SII),采用美国贝克曼尔特特种蛋白分析仪检测两组A-白蛋白及α1、α2、β、γ免疫球蛋白。结果与无运动并发症组比较,有运动并发症组NLR、SII和γ-球蛋白升高,A-白蛋白降低,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示SII、A-白蛋白、γ-球蛋白、H-Y分期是PD运动并发症的危险因素(P<0.05)。ROC工作曲线分析结果显示SII、A-白蛋白、γ-球蛋白和H-Y分期对预测PD运动并发症的AUC值分别为0.752、0.643、0.704、0.746,95%CI分别为0.683~0.822、0.549~0.737、0.619~0.788、0.670~0.823。联合检测的AUC值为0.858,95%CI为0.796~0.920。结论高水平的SII及γ-球蛋白、H-Y分期和较低的A-白蛋白可增加PD发生运动并发症的风险。

Objective To investigate the association of systemic immune inflammatory index and immunoglobulin levels with exercise complications in Parkinson's disease(PD)patients.Methods 218 PD patients diagnosed in the hospital from January 2022 to June 2023 were selected as study subjects.The patients were divided into the group with motor complications and the group without motor complications based on whether their clinical symptoms fluctuated and whether they had dyskinesia.The general data of the 2 groups were collected.The neutrophil lymphocyte ratio(NLR)and systemic immune-inflammation index(SII)were measured by SYSMEX XN-3000 automatic analyzer.The A-albumin andα1,α2,β,γimmunoglobulins in 2 groups were detected by Beckmann's special protein analyzer.Results NLR,SII andγ-globulin were higher and A-albumin was lower in the group with exercise complications than in the group without exercise complications(P<0.05).Logistic regression analysis showed that SII,A-albumin,γ-globulin and H-Y staging were the risk factors of PD motor complications(P<0.05).ROC showed that AUC of SII,A-albumin,γ-globulin and H-Y staging were 0.752,0.643,0.704,0.746 and 95%CI were 0.683-0.822,0.549-0.737,0.619-0.788 and 0.670-0.823.The AUC of combined detection was 0.858,with a 95%CI of 0.796 to 0.920.Conclusion High levels of SII,γ-globulin,H-Y staging and low A-albumin increase the risk of motor complications in PD.