血清胱抑素C联合经颅黑质超声检查在帕金森病诊断中的价值  

Value of serum cystatin C combined with transcranial substantia nigra ultrasound in diagnosis of Parkinson's disease

作　　者：徐辰寒 李杰[1] 吴小云[2] 施俊峰[1] XU Chenhan;LI Jie;WU Xiaoyun;SHI Junfeng(Department of Neurology,Yixing People's Hospital,Yixing 214200,China;Department of Ultrasound,Yixing People's Hospital,Yixing 214200,China)

机构地区：[1]江苏省宜兴市人民医院神经内科,江苏宜兴214200 [2]江苏省宜兴市人民医院超声科,江苏宜兴214200

出　　处：《医学影像学杂志》2022年第10期1653-1657,共5页Journal of Medical Imaging

基　　金：国家自然科学基金青年科学基金项目(编号:81701302);江苏省无锡市卫健委“双百”中青年医疗卫生拔尖人才项目(编号:BJ2020108);江苏省无锡市青年医学重点人才培养项目(编号:QNRC083);江苏省无锡市科技发展医疗卫生指导性计划项目(编号:NZ2019051)。

摘　　要：目的探讨血清胱抑素C联合经颅黑质超声检查在帕金森病(PD)诊断中的价值。方法选取PD患者87例为PD组与102例健康志愿者为对照组,采用单因素和多因素Logistic比例风险回归模型评估血清胱抑素C水平和黑质(SN)强回声面积诊断PD的风险。绘制血清胱抑素C,SN强回声面积以及两者联合诊断PD的ROC曲线并评估其诊断价值,采用方差分析和χ^(2)检验比较PD三组H-Y分期之间的血清胱抑素C水平与SN强回声面积,以双侧P<0.05为差异有统计学意义。结果PD组的血清胱抑素C水平(1.3±0.3)mg/L和SN强回声面积(2.4±0.6)×10^(3)mm^(2)明显高于对照组的(0.8±0.2)mg/L和(1.8±0.4)×10^(3)mm^(2),多因素Logistic回归分析结果显示:血清胱抑素C水平和SN强回声面积均为诊断PD的独立危险因素,血清胱抑素C水平和SN强回声面积两者联合诊断PD的灵敏度为87.2%,特异度为84.5%,AUROC为0.865,三组PD H-Y分期之间血清胱抑素C的整体比较和两两比较均有显著性差异,三组H-Y分期之间SN强回声面积的整体比较和两两比较差异均无统计学意义。结论血清胱抑素C联合SN强回声面积在PD诊断中具有较高的价值。Objective To investigate the value of serum cystatin C combined with transcranial substantia nigra ultrasound in the diagnosis of Parkinson's disease.Methods 87 patients were assigned to into Parkinson's group and 102 healthy persons to control group.Univariate and multivariate logistic proportional hazard regression models were used to assess the risk of diagnosing Parkinson's disease by serum cystatin C level and SN hyperechoic area.The ROC curves of serum cystatin C,SN hyperechoic areas and their combination in the diagnosis of Parkinson's disease were drawn and their diagnostic value was evaluated.The serum cystatin C level and SN hyperechoic area among the three H-Y stages of Parkinson's disease were compared by analysis of variance and χ^(2) test.The difference was statistically significant in bilateral P<0.05.Results Serum Cystatin C level(1.3±0.3)mg/L and SN hyperechoic area(2.4±0.6)×10^(3)mm^(2)in Parkinson's group were significantly higher than(0.8±0.2)mg/L and(1.8±0.4)×10^(3)mm^(2)in healthy control group.Multivariate logistic regression analysis showed that both serum cystatin C level and SN hyperechoic area were independent risk factors for the diagnosis of Parkinson's disease.The sensitivity,specificity and AUROC of the two-method combination in the diagnosis of Parkinson's disease were 87.2%,84.5%and 0.865 respectively.There were significant differences in serum cystatin C between the three H-Y stages,but there was no significant difference in SN hyperechoic area between the three H-Y stages.Conclusion Serum Cystatin C combined with SN hyperechoic area has high value in the diagnosis of Parkinson's disease.

关 键 词：胱抑素C 黑质强回声面积 帕金森病 超声检查 

分 类 号：R745.1[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]