帕金森病患者血清CysC、Hcy水平及其对伴发脑白质病变的评估作用  

Serum levels of cystatin C and homocysteine in patients with Parkinson’s disease and their role in evaluating white matter lesions

作　　者：苏楠[1] 郭雅聪[1] 胡耀凯 马娜[1] 刘小双[1] 李海霞 SU Nan;GUO Ya-Cong;HU Yao-Kai;MA Na;LIU Xiao-Shuan;LI Hai-Xia(Department of Neurology,Puyang People’s Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市人民医院神经内科,河南濮阳457000

出　　处：《国际神经病学神经外科学杂志》2021年第6期511-515,共5页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨帕金森病患者血清胱抑素C(CysC)、同型半胱氨酸(Hcy)水平及其对伴发脑白质病变的评估作用。方法回顾性分析2017年12月至2019年12月该院收治的124例帕金森病患者(研究组)和115例在该院进行体检的健康志愿者(对照组)的资料。结果研究组血清CysC、Hcy水平分别为(1.37±0.25)mg/L、(0.89±0.14)μmol/L,均高于对照组的(20.54±3.21)mg/L、(14.89±2.18)μmol/L,差异有统计学意义(P<0.05)。研究组患者中有35例伴发脑白质病变,发生率为28.23%;研究组中伴发脑白质病变者的血清CysC、Hcy水平分别为(1.58±0.29)mg/L、(23.32±3.58)μmol/L,高于无伴发脑白质病变者的(1.29±0.22)mg/L、(19.45±3.12)μmol/L,差异有统计学意义(P<0.05)。年龄、帕金森病病程、高血压病、糖尿病、血清CysC、Hcy均是研究组伴发脑白质病变的危险因素(P<0.05)。血清CysC、Hcy水平评估伴发脑白质病变的Cut-off值分别为1.25 mg/L、21.02μmol/L,二者联合评估帕金森病伴发脑白质病变的灵敏度、AUC分别为100.00%、0.953,均高于单独指标评估(P<0.05)。结论帕金森病患者血清CysC、Hcy水平偏高,伴发脑白质病变的风险高;血清CysC、Hcy与年龄、帕金森病病程、高血压病、糖尿病等均是其影响因素;血清CysC、Hcy水平联合评估帕金森病伴发脑白质病变的效能高。Objective To investigate the serum levels of cystatin C(Cys C)and homocysteine(Hcy)in patients with Parkinson’s disease(PD)and their role in evaluating white matter lesions.Methods A retrospective analysis was performed for the data of 124 PD patients who were admitted to our hospital from December 2017 to December 2019(study group)and115 healthy volunteers who underwent physical examination in our hospital during the same period of time(control group).Results Compared with the control group,the study group had significantly higher serum levels of Cys C(1.37±0.25 mg/L vs 0.89±0.14 mg/L,P<0.05)and Hcy(20.54±3.21 μmol/L vs 14.89±2.18 μmol/L,P<0.05). In the study group,35 patients had white matter lesions,with an incidence rate of 28.23%,and compared with the patients without white matter lesions,the patients with white matter lesions had significantly higher serum levels of Cys C(1.58±0.29 mg/L vs 1.29±0.22 mg/L,P<0.05)and Hcy(23.32±3.58 μmol/L vs 19.45±3.12 μmol/L,P<0.05). Age,the course of PD,hypertension,diabetes,serum Cys C,and Hcy were all independent risk factors for PD with white matter lesions(P<0.05). Serum levels of Cys C and Hcy had cut-off values of 1.25 mg/L and 21.02 μmol/L,respectively,in evaluating white matter lesions,and the combination of Cys C and Hcy had a sensitivity of 100.00% and an area under the ROC curve(AUC)of 0.953 in evaluating PD with white matter lesions,which were significantly higher than the sensitivity and AUC of each index alone(P<0.05).Conclusions Patients with PD have relatively high serum levels of Cys C and Hcy and a high risk of white matter lesions.Serum Cys C and Hcy,age,the course of PD,hypertension,and diabetes are related influencing factors,and the combination of serum Cys C and Hcy has high performance in evaluating PD with white matter lesions.

关 键 词：帕金森病 胱抑素C 同型半胱氨酸 脑白质病变 

分 类 号：R742.5[医药卫生—神经病学与精神病学]