摘要
目的探讨血清胱抑素C（Cys-C）表达变化对初诊帕金森病患者轻度认知损害的早期诊断价值。方法共101例初诊帕金森病患者分为帕金森病轻度认知损害组（PD-MCI组,43例）和帕金森病认知功能正常组（对照组,58例）,循环酶法检测血清Cys-C、脂质、肌酐和尿酸水平,简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（Mo CA）评价认知功能;Logistic回归分析评价血清Cys-C与认知功能间的相关性;受试者工作特征曲线（ROC曲线）计算血清Cys-C早期诊断帕金森病轻度认知损害之灵敏度、特异度和准确率。结果 PD-MCI组患者血清Cys-C水平高于对照组[（1.12±0.10）mg/L对（1.00±0.15）mg/L,P=0.000]。各项危险因素筛查仅血清Cys-C为帕金森病患者轻度认知损害的独立危险因素（OR=4.285,95%CI：1.301-14.112;P=0.017）,且与MMSE总评分（rs=-0.831,P=0.000）和Mo CA总评分（rs=-0.848,P=0.000）,以及视空间能力和执行功能（rs=-0.495,P=0.001）、注意力和计算力（rs=-0.339,P=0.026）、延迟回忆（rs=-0.307,P=0.045）评分均呈负相关;ROC曲线下面积为0.707（95%CI：0.603~0.811,P=0.000）,诊断灵敏度和特异度分别为53.50%和82.80%,所对应的血清Cys-C临界值为1.105 mg/L。结论血清Cys-C表达水平升高可能与初诊帕金森病患者轻度认知损害密切相关,具有早期诊断参考价值。
Objective To investigate the diagnostic value of expression level of serum cystatin C（Cys- C） on early diagnosis of newly diagnosed Parkinson＇s disease with mild cognitive impairment（PD-MCI）.Methods A total of 101 PD patients were divided into 2 groups： PD-MCI gruop（N = 43） and PDwith normal cognition group（control group, N = 58）. The levels of serum Cys-C, lipid, creatinine（Cr） anduric acid（UA） were tested. Mini-Mental State Examination（MMSE） and Montreal Cognitive Assessment（Mo CA） were used to evaluate cognitive function, and Logistic regression analysis was used to evaluate thecorrelation between PD-MCI and the level of serum Cys-C. Receiver operating characteristic（ROC） curvewas used to detect the sensitivity and specificity of early diagnosis.Results The expression level ofsPe rum Cys-C in PD-MCI group [（1.12 ± 0.10） mg/L] was higher than that of control group [（1.00 ± 0.15） mg/L,= 0.000]. Univariate and multivariate Logistic regression analysis showed that serum Cys- C was theindependent risk factor for PD- MCI（OR = 4.285, 95% CI： 1.301-14.112; P = 0.017）; Spearman rankcorrelation analysis showed the expression level of serum Cys-C was negatively correlated with MMSE totalscore（rs=- 0.831, P = 0.000）, Mo CA total score（rs=- 0.848, P = 0.000）, visuospatial/executive function（rs=- 0.495, P = 0.001）, attention/counting（rs=- 0.339, P = 0.026） and delayed recall（rs=- 0.307, P P = 0.045）.ROC curve analysis showed that area under the curve（AUC） was 0.707（95%CI： 0.603-0.811, = 0.000）.Diagnostic sensitivity and specificity were 53.50% and 82.80% respectively, and the critical value of serumCys- C level was 1.105 mg/L.Conclusions Increased expression level of serum Cys- C maybe closelyrelated with newly diagnosed PD-MCI, and has a certain value to the early diagnosis of PD-MCI.
出处
《中国现代神经疾病杂志》
CAS
2015年第8期638-644,共7页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
科技部"重大新药创制"重大专项项目(项目编号:2012ZX09303-003)
科技部"重大新药创制"重大专项项目(项目编号:2012ZX09303005-002)
国家自然科学基金资助项目(项目编号:81471215)
国家自然科学基金资助项目(项目编号:81271211)
国家自然科学基金资助项目(项目编号:30700248)
江苏省科技支撑计划项目(项目编号:BE2011614)
江苏省重点实验室开放课题(项目编号:SJ11KF05)
江苏省"333高层次人才培养工程"资助项目[项目编号:(2013)Ⅲ-0077号]
江苏省"六大人才高峰"资助项目(项目编号:2012-WS-002)
江苏省扬州市"绿扬金凤计划"创新领军人才项目(项目编号:yzlyjfjh2013CX056)~~
关键词
半胱氨酸蛋白酶抑制剂
帕金森病
认知障碍
危险因素
回归分析
Cysteine proteinase inhibitors
Parkinson disease
Cognition disorders
Riskfactors
Regression analysis
