眼震电图视跟踪实验对帕金森病患者发病筛查的可行性

Feasibility of electronystagmogram follow-up test for screening patients with Parkinson's disease

目的 探究眼震电图视跟踪实验对帕金森病(PD)患者发病筛查的可行性。方法 回顾性选取2020年2月~2023年2月于沧州市人民医院进行眼震电图视跟踪实验的188例受检者,均使用视频眼震电图仪对其眼动系统进行检查,根据是否发生PD分为发病组(60例)和健康组(128例)。观察两组的一般资料,并分析影响PD患者发病的独立预测因子及构建预测模型;分析不同Hoehn-Yahr分级PD患者的独立预测因子的差异,其对于不同发病程度的预测价值。结果 188例研究者中发生PD的患者有60例,健康者128例。发病组患者左扫视角度°20°、25°及右向扫视角度15°、30°的扫视速度较健康组有所延长,差异有统计学意义(P<0.05)。logistic回归结果显示,左扫视角度20°、25°及右向扫视角度15°、30°是PD病患者发病的独立预测因子(P<0.05)。对不同Hoehn-Yahr分级的患者进行比较发现,随着病情的发展和恶化,左扫视角度20°、25°及右向扫视角度15°、30°的扫视速度愈加缓慢。logistic回归结果显示左扫视角度20°、25°及右向扫视角度15°、30°是PD病患者病情发展程度的独立预测因子(P<0.05)。结论 左扫视角度20°、25°及右向扫视角度15°、30°是PD患者发病的预测因子,且随着病情加重,差异越显著。使用左向扫视角度25°、右向扫视角度15°及30°联合诊断对PD发病和疾病发展程度的预测价值较高,故在对PD患者进行治疗的过程中,动态监测相关预测因子的变化,可为临床预防PD发病及早诊断提供科学依据与理论指导。

Objective To explore the feasibility of electronystagmogram follow-up test in screening patients with Parkinson's disease.Methods Retrospectively selected 188 subjects who underwent the nystagmographic visual tracking experiment in our hospital from February 2020 to February 2023,and were divided into the onset group(60 cases)and the healthy group(128 cases)according to whether Parkinson's occurred or not.All of them had their oculomotor system examined using a video nystagmograph,observed the general data of the 2 groups,and analysed the independent predictors affecting the onset of Parkinson's disease patients and constructed a prediction model;further analysed the differences of the independent predictors of Parkinson's disease patients with different Hoehn-Yahr grades,and analysed the predictive value for different degrees of onset.Results Among 188 investigators,there were 60 patients with PD and 128 healthy subjects.The saccade speed of patients in the attack group with left saccade angles of 20 and 25 and right saccade angles of 15 and 30 was longer than that of the healthy group(P<0.05).Logistic regression showed that left saccade angles of 20 and 25 and right saccade angles of 15 and 30 were independent predictors of PD patients.Comparing patients with different Hoehn-Yahr grades,it was found that the scanning speed of left angles 20 and 25 and right angles 15 and 30 became slower with the development and worsening of the disease.Logistic regression showed that left saccade angles 20 and 25 and right saccade angles 15 and 30 were independent predictors of PD progression.The ROC results showed that the AUC of the combination of left eye angle 20,25 and right eye angle 15,30 was 0.988,and the sensitivity and specificity were 99.00%and 98.00%,respectively,which had the highest predictive value.Conclusion Left gaze angle 20,25 and right gaze angle 15,30 are predictors of Parkinson's disease,and the difference is more significant as the disease worsens.The combined diagnosis of left gaze angle 25 and right gaze angle 15,30 has a higher predictive value for the onset and progression of Parkinson's disease,so dynamic monitoring of changes in related predictors may provide a scientific basis and theoretical guidance for clinical prevention and early diagnosis of Parkinson's disease.