帕金森病患者血尿酸及同型半胱氨酸水平与认知障碍的相关性研究

Study on the Correlation Between Serum Uric Acid and Homocysteine in Patients with Parkinson's disease and their Cognitive Dysfunction

目的本研究的目的是探讨血尿酸(uric acid,UA)、同型半胱氨酸(homocysteine,HCY)水平与帕金森病(parkinson’s disease,PD)患者的病情分期、认知功能改变的相关性。方法选择我院2015—2018年收治的PD患者和健康体检者各60例为研究对象,对肌酐、UA、HCY水平进行检测,使用Hoehn-Yahr(H-Y)分期,将PD组患者分为早期组(1~2.5期)、中晚期组(3~5期)两个亚组,使用蒙特利尔认知评估量表将帕金森病患者分成认知功能障碍组及认知功能正常组两个亚组。比较分析帕金森病患者与正常对照组及PD各亚组之间的尿酸、同型半胱氨酸水平有无差异。结果(1)PD组的UA水平明显低于对照组。(2)PD组的HCY水平明显高于对照组。(3)PD中晚期组的UA水平低于早期组,PD中晚期组的HCY水平明显高于PD早期组。(4)PD认知障碍组的UA水平低于认知功能正常组。(5)PD认知功能障碍组的HCY水平高于PD认知功能正常组。结论检测UA、HCY水平可能在发现早期PD及其早期认知功能障碍方面有重要价值;在一定范围内提高UA水平同时降低HCY水平可能为控制或延缓PD快速进展、改善PD认知功能等提供潜在的治疗意义。

Objective The purpose of this study was to investigate the relationship between levels of uric acid(UA),homocysteine(HCY),and stage and cognitive function changes in Parkinson's disease(PD).Through this study,we seek a new path for the diagnosis of early PD and early cognitive impairments,thereby giving early intervention and reducing complications.Methods A total of 60 PD patients and 60 healthy checkers admitted to our hospital from 2015 to 2018 were selected as the study subjects.And measure their serum uric acid,creatinine,and homocysteine concentrations.Using Hoehn-Yahr(H-Y)staging,patients in the PD group were divided into two subgroups:The early(1-2.5)and mid-late(3-5)groups.Using the Montreal cognitive assessment(MoCA),PD was divided into two subgroups:cognitive dysfunction and normal cognitive function.We compared the levels of serum UA and HCY between patients with Parkinson's disease and normal controls and between PD subgroups.Results(1)Serum UA levels in the PD group were significantly lower than those in the control group.(2)The serum HCY level in the PD group was significantly higher than that in the control group.(3)Serum UA in the mid-late PD group was lower than that in the early group.HCY levels in the mid-late PD group were significantly higher than those in the early PD group.(4)Serum UA in PD cognitive impairment group was lower than that in normal cognitive function group.(5)HCY levels in PD cognitive dysfunction group were higher than PD cognitive function normal group.Conclusion Serum uric acid and homocysteine may play an important role in the detection of early PD and its early cognitive dysfunction.Increasing blood UA and reducing HCY may be the strategies to control or delay the rapid progression of PD and improve cognitive function.