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| 血管性帕金森综合征患者氧化应激反应与认知功能的相关性分析 |
| Correlation between oxidative stress and cognitive function in patients with vascular Parkinson"s syndrome |
| 投稿时间：2023-12-26 修订日期：2023-12-26 |
| DOI： |
| 中文关键词: 血管性帕金森综合征 超氧化物歧化酶 丙二醛 认知功能 |
| 英文关键词: vascular Parkinson's syndrome Superoxide dismutase Malondialdehyde Cognitive function |
| 基金项目:河北省张家口市2020年市级科技计划项目(编号：2021034D) |
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| 中文摘要: |
| 目的：分析血管性帕金森综合征(VPS)患者氧化应激反应与认知功能的相关性。方法：选定本院神经内科2020年11月至2022年11月接诊的64例VPS患者进行回顾性研究,将其设为VPS组,另选取同期医院接诊的64例帕金森病(PD)患者,将其设为PD组,以及同期本院体检中心64例健康体检者,将其设为健康组,以蒙特利尔认知评估量表(MoCA)评分评估受检者认知功能,检测、比较三组氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、MoCA评分,根据Hoehn-Yahr(H-Y)分级将VPS组患者分为早期组(29例)、中晚期组(35例),根据McCA评分将VPS组患者分为有认知功能障碍组(44例)、无认知功能障碍组(20例),比较早、中晚期组氧化应激指标、MoCA评分,比较有、无认知功能障碍组氧化应激指标,Pearson分析血清SOD、MDA与MoCA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SOD、MDA对认知功能障碍的预测价值,单因素、多因素logistic回归分析VPS患者发生认知功能障碍的危险因素。结果：VPS组血清MDA高于PD组、健康组(P＜0.05),VPS组血清SOD、MoCA评分均低于PD组、健康组(P＜0.05)。中晚期组血清MDA高于早期组(P＜0.05),中晚期组血清SOD、MoCA评分均低于早期组(P＜0.05)。有认知功能障碍组血清MDA高于无认知功能障碍组(P＜0.05),有认知功能障碍组血清SOD低于无认知功能障碍组(P＜0.05)。血清SOD与MoCA评分呈正相关性(P＜0.05)(r值=0.398),血清MDA与MoCA评分呈负相关性(P＜0.05)(r值=-0.432)。SOD、MDA联合检测预测认知功能障碍的AUC是0.811,(95%CI:0.727-0.954),灵敏度(93.28%)、特异度(90.17%)均高于SOD(76.67%、74.09%)、MDA(74.28%、71.46%)单独检测(P＜0.05)。年龄、高尿酸血症、血清Hcy、脑梗死部位、脑梗死面积、微出血、SOD、MDA是VPS患者发生认知功能障碍的危险因素(P＜0.05)。结论：VPS患者血清MDA呈异常高表达,血清SOD呈异常低表达,共同参与了VPS疾病进展,与患者认知功能存在一定联系,联合检测MDA、SOD可提高对VPS患者认知功能障碍的预测效能,另外,诱发认知功能障碍的影响因素较多,应当引起临床重视。 |
| 英文摘要: |
| Objective: To analyze the correlation between oxidative stress and cognitive function in patients with vascular Parkinson"s syndrome (VPS). Method: 64 cases of VPS patients admitted to the Department of Neurology of our hospital from November 2020 to November 2022 were selected as the VPS group for retrospective study; 64 cases of Parkinson"s disease (PD) patients admitted to the hospital during the same period were selected as the PD group, and 64 cases of healthy physical examination patients in the physical examination center of our hospital during the same period were selected as the healthy group. The cognitive function of the subjects was evaluated by the Montreal Cognitive Assessment Scale (MoCA) score, and the oxidative stress index [superoxide dismutase (SOD), malonaldehyde (MDA)] and MoCA score of the three groups were detected and compared. According to the Hoehn-Yahr (H-Y) scale, the patients in the VPS group were divided into the early group (29 cases) and the middle and late group (35 cases). According to McCA score, the VPS group was divided into a group with cognitive dysfunction (44 cases) and a group without cognitive dysfunction (20 cases). The oxidative stress index and MoCA score of the early, middle and late groups were compared, and the oxidative stress index of the group with and without cognitive dysfunction was compared. Pearson analyzed the correlation between serum SOD, MDA and MoCA score. Receiver operating curve (ROC) was plotted, area under curve (AUC) was calculated, and the predictive value of SOD and MDA to cognitive dysfunction was analyzed.The risk factors of cognitive dysfunction in VPS patients were analyzed by univariate and multivariate logistic regression. Results: The serum MDA of VPS group was higher than that of PD group and healthy group (P<0.05), and the serum SOD and MoCA scores of VPS group were lower than those of PD group and healthy group (P<0.05). The serum MDA of middle and late group was higher than that of early group (P<0.05), and the serum SOD and MoCA scores of middle and late group were lower than those of early group (P<0.05). The serum MDA of the group with cognitive dysfunction was higher than that of the group without cognitive dysfunction (P<0.05), and the serum SOD of the group with cognitive dysfunction was lower than that of the group without cognitive dysfunction (P<0.05). Serum SOD was positively correlated with MoCA score (P<0.05) (r=0.398), and serum MDA was negatively correlated with MoCA score (P<0.05) (r=-0.432). The AUC of SOD and MDA combined detection in predicting cognitive dysfunction was 0.811 (95%CI:0.727-0.954). The sensitivity (93.28%) and specificity (90.17%) were higher than those of SOD (76.67%, 74.09%) and MDA (74.28%, 71.46%) alone (P<0.05).Age, hyperuricemia, serum Hcy, site of cerebral infarction, size of cerebral infarction, microhemorrhage, SOD and MDA were risk factors for cognitive dysfunction in VPS patients(P<0.05). Conclusion: Serum MDA and serum SOD are abnormally high expression and abnormally low expression in VPS patients, which jointly participate in the progression of VPS disease and are associated with the cognitive function of patients. The combined detection of MDA and SOD can improve the predictive efficacy of cognitive dysfunction in VPS patients. In addition, there are many influencing factors inducing cognitive dysfunction, which should be paid clinical attention. |
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