【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。更多还原

【Abstract】 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.更多还原