神经递质与血管性帕金森综合征患者运动障碍的关系及预测价值研究  

Association between neurotransmitters and dyskinesia in patients with vascular Parkinson syndrome and the predictive value of neurotransmitters

作　　者：孙健[1] 郝光[1] 贺宏梅 安娜 薛茜[1] SUN Jian;HAO Guang;HE Hongmei(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《中风与神经疾病杂志》2023年第8期697-701,共5页Journal of Apoplexy and Nervous Diseases

基　　金：河北省张家口市2020年市级科技计划自筹经费项目(2021034D)。

摘　　要：目的分析神经递质与血管性帕金森综合征(VPS)患者运动障碍的关系及预测价值。方法选定本院神经内科2020年12月-2022年12月住院的60例VPS患者进行回顾性研究,将其设为观察组;另选取同期本院住院的60例帕金森病(PD)患者,将其设为对照组;同期本院体检中心60例健康体检者,将其设为健康组。以简化Fugl-Meyer运动功能评定量表(FMA)评分评估患者运动功能,检测、比较3组血清神经递质[5-羟色胺(5-HT)、多巴胺(DA)]、FMA评分,比较VPS患者中不同Hoehn-Yahr分期组血清神经递质、FMA评分,比较VPS患者中不同运动功能障碍组血清神经递质,Pearson分析血清5-HT、DA与FMA评分的相关性,绘制受试者工作曲线(ROC),计算曲线下面积(AUC),分析5-HT、DA对运动功能障碍的预测效能。结果观察组血清5-HT、DA、FMA评分均低于对照组、健康组(P<0.05),对照组血清5-HT、DA、FMA评分均低于健康组(P<0.05)。Ⅳ期组血清5-HT、DA、FMA评分均低于Ⅲ期组,Ⅲ期组血清5-HT、DA、FMA评分均低于Ⅱ期组(P<0.05)。严重运动障碍组血清5-HT、DA均低于明显运动障碍组(P<0.05),明显运动障碍组血清5-HT、DA均低于中度运动障碍组(P<0.05),中度运动障碍组血清5-HT、DA均低于轻度运动障碍组(P<0.05)。血清5-HT、DA与FMA评分均呈正相关性(P<0.05)(r值=0.411、0.403)。5-HT、DA联合检测预测运动功能障碍的AUC是0.803,(95%CI 0.713~0.938),灵敏度(92.72%)、特异度90.83%(90.83%)均高于单一检测(75.27%、72.64%)、(72.87%、70.09%)(P<0.05)。结论VPS患者运动障碍与血清5-HT、DA异常低表达联系密切,两者共同参与了运动功能障碍中,联合检测血清5-HT、DA可提高对运动功能障碍的预测效能,具有一定的参考价值。Objective To investigate the association between neurotransmitters and dyskinesia in patients with vascular Parkinson syndrome(VPS)and the predictive value of neurotransmitters.Methods A retrospective analysis was performed for 60 patients with VPS who were hospitalized in Department of Neurology in our hospital from December 2020 to December 2022,and they were enrolled as observation group;60 patients with Parkinson disease who were hospitalized in our hospital during the same period of time were enrolled as control group;60 patients who underwent physical examination in the Physical Examination Center of our hospital during the same period of time were enrolled as healthy group.The simplified Fugl-Meyer Assessment(FMA)score was used to evaluate the motor function of patients.The above three groups were compared in terms of serum neurotransmitters[5-hydroxytryptamine(5-HT),dopamine(DA)]and FMA score;the VPS patients with different Hoehn-Yahr stages were compared in terms of serum neurotransmitters and FMA score;the VPS patients with different severities of dyskinesia were compared in terms of serum neurotransmitters.A Pearson correlation analysis was used to investigate the correlation of serum 5-HT and DA with FMA score;the receiver operating characteristic(ROC)curve was plotted and the area under the ROC curve(AUC)was calculated to analyze the efficacy of 5-HT and DA in predicting dyskinesia.Results The observation group had significantly lower serum 5-HT and DA and FMA score than the control group and the healthy group(P<0.05),and the control group had significantly lower serum 5-HT and DA and FMA score than the healthy group(P<0.05).The stageⅣgroup had significantly lower serum 5-HT and DA and FMA score than the stageⅢgroup,and the stageⅢgroup had significantly lower serum 5-HT and DA and FMA score than the stageⅡgroup(P<0.05).The severe dyskinesia group had significantly lower serum 5-HT and DA than the obvious dyskinesia group(P<0.05),the obvious dyskinesia group had significantly lower serum 5-HT

关 键 词：5-羟色胺 多巴胺 血管性帕金森综合征 运动功能障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学]