摘要
目的探讨早期帕金森病(PD)患者血清胱抑素C(CysC)、同型半胱氨酸(Hcy)水平与睡眠障碍的相关性。方法选择本院神经内科92例早期PD患者为病例组,依据匹兹堡睡眠质量指数分为睡眠无障碍患者40例,睡眠障碍患者52例,选择87名健康者为对照组;评价各组临床基本资料,测定各组CysC、Hcy、谷氨酸(Glu)、γ-氨基丁酸(GABA)水平。结果睡眠障碍组左旋多巴胺等效剂量、PSQI水平高于睡眠无障碍组(P<0.05),而在病程、MMSE评分、UPDRS评分、H-Y分级的水平与对照组相似(P>0.05);睡眠障碍组CysC、Hcy水平高于睡眠无障碍组、对照组,睡眠无障碍组CysC、Hcy水平高于对照组(P<0.05);睡眠障碍组Glu、GABA水平低于睡眠无障碍组、对照组,睡眠无障碍组Glu、P、GABA水平低于对照组(P<0.05);CysC、Hcy与MMSE评分、H-Y分级、PSQI正相关关系明显,与左旋多巴胺等效剂量、UPDRS评分、Glu、GABA负相关关系明显(P<0.05);高水平的PSQI、CysC、Hcy均为早期PD发生睡眠障碍的危险因素(OR=4.62、5.02、17.89,P<0.05);CysC、Hcy两者的AUC相近(P>0.05),皆小于PSQI(P<0.05),CysC、Hcy诊断早期PD睡眠障碍的灵敏度、特异度相近(P>0.05),皆小于PSQI(P<0.05)。结论早期PD患者血清CysC、Hcy水平升高,与睡眠障碍程度正相关关系明显;高水平的CysC、Hcy均为早期PD发生睡眠障碍的危险因素。
Objective To investigate relationship between serum cystatin C(CysC)and homocysteine(Hcy)levels and sleep disorders in patients with early Parkinson's disease(PD).Methods 92 patients with early PD(case group)including 40 cases of sleep disorder-free patients and 52 cases of sleep disorder patients as well as 87 healthy individuals(control group)were selected.The basic clinical data of each group were evaluated and the serum levels of CysC,Hcy,Glu and GABA were measured.Results Levodopamine equivalent dosage and PSQI level in the sleep disorder group were higher than those in the sleep disorder-free group(P<0.05),while course,MMSE score,UPDRS score and H-Y grade had no difference between the sleep disorder group and control group(P>0.05).The levels of CysC and Hcy ranking in a descending order was sleep disorder group,sleep disorder-free group and control group,with statistic difference(P<0.05).The levels of Glu and GABA ranking in an ascending order was sleep disorder group,sleep disorder-free group and control group,with statistic difference(P<0.05).CysC and Hcy were positively correlated with MMSE score,H-Y grade and PSQI,and negatively correlated with L-dopamine equivalent dosage,UPDRS score,Glu and GABA(P<0.05).High levels of PSQI,CysC,and Hcy were risk factors for sleep disorders in patients with early PD(OR=4.62,5.02,17.89,P<0.05);The AUC,sensitivity and specificity of CysC and Hcy in the diagnosis of early Parkinson's sleep disorder were similar(P>0.05),which were all less than PSQI(P<0.05).Conclusion The serum levels of CysC and Hcy in early PD are positively correlated with the degree of sleep disorder,which indicates that the two indicators are risk factors for early PD,moreover,CysC and Hcy have high sensitivity and specificity in the diagnosis of sleep disorder,which is worthy of clinical application.
作者
邹瑜
钟纯正
郭春宣
王御林
Zou Yu;Zhong Chunzhen;Guo Chunxuan;Wang Yulin(Department of Neurology,the Danzhou People's Hospital,Hainan 571700,China)
出处
《脑与神经疾病杂志》
2020年第2期96-100,共5页
Journal of Brain and Nervous Diseases
基金
海南省卫生计生行业科研项目（16A200073）
