帕金森病患者血清25-羟维生素D_(3)和脑黑质铁沉积量变化及意义  

Changes and clinical significances of serum 25-hydroxyvitamin D_(3) and iron deposition in the substantia nigra of Parkinson's disease patients

作　　者：穆清爽[1] 李瑞晟[1] 李沛珊 杨新玲[2] MU Qingshuang;LI Ruisheng;LI Peishan;YANG Xinling(Department of Geriatrics,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830063,China;Department of Neurology,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830063,China)

机构地区：[1]新疆医科大学第二附属医院老年病综合科,新疆维吾尔自治区乌鲁木齐830063 [2]新疆医科大学第二附属医院神经内科,新疆维吾尔自治区乌鲁木齐830063

出　　处：《中华实用诊断与治疗杂志》2024年第9期899-903,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(82160232);新疆神经系统疾病研究重点实验室开放课题项目(XJDX1711-2245)。

摘　　要：目的观察帕金森病(PD)患者血清25-羟维生素D_(3)[25(OH)D_(3)]、氧化应激指标及脑黑质铁沉积量变化,探讨其与PD的关系。方法2021年4月—2023年4月新疆医科大学第二附属医院诊治PD患者71例为PD组,同期健康体检者71例为对照组。2组采用分光光度法测定血清25(OH)D_(3)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)和丙二醛(MDA)水平;行头颅MRI定量磁化率成像(QSM)序列扫描,记录脑黑质中铁沉积量QSM值。PD患者入院后采用帕金森病评定量表评分(UPDRS)评估PD严重程度,采用帕金森氏睡眠量表评分(PDSS)评估睡眠质量,采用非运动症状问卷量表(NMSQ)评估非运动症状,采用Pearson相关法分析血清25(OH)D_(3)、QSM值与UPDRS、PDSS及NMSQ评分的相关性。结果(1)PD组血清25(OH)D_(3)[(14.54±6.56)μg/L]、SOD[(98.11±23.99)u/mL]和GSH[(19.39±8.40)μmol/L]水平均低于对照组[(31.81±11.20)μg/L、(124.31±29.43)u/mL、(68.63±33.06)μmol/L](t=8.276,P<0.001;t=2.858,P=0.007;t=6.111,P<0.001),QSM值(124.33±39.41)高于对照组(72.81±21.24)(t=4.386,P<0.001),血清MDA[(4.38±1.48)μmol/L]与对照组[(5.38±2.87)μmol/L]比较差异无统计学意义(t=1.286,P=0.208)。(2)PD患者UPDRS为(50.49±5.76)分,PDSS为(112.70±6.73)分,NMSQ评分为(13.63±2.86)分。血清25(OH)D_(3)与UPDRS(r=-0.483,P<0.001)、NMSQ评分(r=-0.278,P=0.028)均呈负相关,与PDSS(r=0.320,P=0.011)呈正相关;QSM值与UPDRS(r=0.380,P=0.003)、NMSQ评分(r=0.380,P=0.003)均呈正相关,与PDSS(r=-0.269,P=0.037)呈负相关。结论PD患者血清25(OH)D_(3)水平降低,脑黑质铁沉积量增加,氧化应激导致的铁沉积可能参与PD的发病、进展。Objective To observe the changes of serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)],oxidative stress indexes and iron deposition in the substantia nigra of Parkinson's disease(PD)patients,and to explore their correlations with PD.Methods From April 2021 to April 2023,71 PD patients(PD group)were diagnosed and treated in the Second Affiliated Hospital of Xinjiang Medical University,and another 71 healthy subjects(control group)received physical examination at the same period.The levels of serum 25(OH)D_(3),superoxide dismutase(SOD),glutathione(GSH)and malondialdehyde(MDA)were detected by spectrophotometric method.All PD patients received quantitative susceptibility mapping(QSM)to record iron deposition volume in the substantia nigra.Unified Parkinson's Disease Rating Scale(UPDRS)was used to evaluate the severity of PD.Parkinson's Disease Sleep Scale(PDSS)was used to evaluate the sleep quality.Non-Motor Symptoms Questionnaire(NMSQ)was used to evaluate non-motor symptoms.Pearson's correlation coefficient was used to analyze the correlations of 25(OH)D_(3) level and QSM value with UPDRS,PDSS and NMSQ scores.Results(1)The serum levels of 25(OH)D_(3),SOD and GSH were lower in PD group[(14.54±6.56)μg/L,(98.11±23.99)u/mL,(19.39±8.40)μmol/L]than those incontrol group[(31.81±11.20)μg/L,(124.31±29.43)u/mL,(68.63±33.06)μmol/L](t=8.276,P<0.001;t=2.858,P=0.007;t=6.111,P<0.001),the QSM value was higher in PD group(124.33±39.41)than that in control group(72.81±21.24)(t=4.386,P<0.001),and the serum MDA showed no significant difference between two groups[(4.38±1.48)μmol/L vs.(5.38±2.87)μmol/L](t=1.286,P=0.208).(2)The scores of UPDRS,PDSS and NMSQ of PD patients were 50.49±5.76,112.70±6.73and 13.63±2.86,respectively.The serum 25(OH)D_(3) level was negatively correlated with UPDRS score(r=-0.483,P<0.001)and NMSQ score(r=-0.278,P=0.028),and positively correlated with PDSS score(r=-0.320,P=0.011).The QSM value was positively correlated with UPDRS score(r=0.380,P=0.003)and NMSQ score(r=0.380,P=0.003),and negatively correl

关 键 词：帕金森病 25-羟维生素D_(3) 氧化应激 脑黑质 铁沉积 

分 类 号：R742.5[医药卫生—神经病学与精神病学]