血脂、胱抑素C、同型半胱氨酸与帕金森病及其亚型的相关性

发布时间：2018-03-13 20:24

本文选题：帕金森病　切入点：血脂　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究血脂、血清胱抑素C(CysC)、同型半胱氨酸(Hcy)与帕金森病的关系,探索上述指标与帕金森病运动分型、发病年龄分型及病情严重程度分组之间的关系,并探讨其与年龄、病程及左旋多巴用量之间的相关性。方法:选择161例帕金森病患者为病例组,107例健康体检者为对照组,比较两组的一般资料及MMSE评分、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、脂蛋白a(Lpa)以及Cys C、Hcy的水平,采用Logistic回归分析研究帕金森病的危险因素;将病例组按照Hoehr-Yahr分级进行病情严重程度分组,按主要的运动症状及起病年龄分别分型,比较上述指标在不同分组、不同分型间的差异;对有差异的指标使用Spearman法分析其与年龄、病程及左旋多巴等效剂量的相关性。绘制ROC曲线分析上述指标对帕金森病的诊断价值。结果:帕金森病组的血清TC、TG、ApoB水平较对照组低,HDL-C、Hcy、CysC水平较对照组高(P0.05);血清ApoB水平降低和HDL-C、Hcy水平升高是帕金森病的独立危险因素(P0.05)。早发型患者血清CysC水平低于晚发型患者(P0.05)。帕金森病患者血清Hcy(r=0.199,P0.05)、Cys C(r=0.283,P0.05)与年龄呈正相关,TG与年龄(r=-0.203,P0.05)、病程(r=-0.199,P0.05)呈负相关,UPDRSIII评分与病程(r=0.436,P0.05)、左旋多巴等效剂量(r=0.424,P0.05)呈正相关。血清ApoB诊断帕金森病的ROC曲线下面积为0.341(P0.05),对帕金森病无诊断价值;血清HDL-C诊断帕金森病的ROC曲线下面积为0.588(P0.05),对帕金森病有较低诊断价值,对应的HDL-C界限值为1.135 mmol/L,诊断灵敏度60.2%,特异度53.3%;血清Hcy诊断帕金森病的ROC曲线下面积为0.643(P0.05),对帕金森病有较低的诊断价值,对应的Hcy界限值为16.5μmol/L,诊断灵敏度60.2%,特异度65.4%。结论:血清低TC、TG、ApoB,高HDL-C、Hcy、CysC可能与帕金森病的发生发展相关;血清ApoB水平降低和HDL-C、Hcy水平升高是帕金森病的独立危险因素;早发型帕金森病与晚发型帕金森病在疾病的发生发展机制上可能存在差异。
[Abstract]:Objective: to study the relationship between serum lipid, serum cystatin cystatin (cystatin) and Parkinson's disease (PD), and to explore the relationship between the above indexes and motor type, age type and severity of Parkinson's disease, and to explore the relationship between these indexes and age. Methods: a total of 161 Parkinson's disease patients were selected as the control group and 107 healthy persons as the control group. The general data and MMSE score of the two groups were compared. The levels of serum total cholesterol (TCC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A 1 (APA), apolipoprotein B (APC), lipoprotein C (LPA) and Cys Con (Hcy) were determined by Logistic regression analysis. The risk factors of Parkinson's disease were analyzed by Logistic regression analysis. The patients were divided into two groups according to the severity of the disease according to the Hoehr-Yahr classification, the patients were classified according to the main motor symptoms and onset age, and the differences of the above indexes were compared between different groups and different types, and the different indexes were analyzed by Spearman method. The correlation between the course of disease and the equivalent dose of levodopa. The ROC curve was drawn to analyze the diagnostic value of the above indexes in Parkinson's disease. Results: the serum TCU TGP ApoB level in Parkinson's disease group was lower than that in the control group (P 0.05) and the serum ApoB water level was higher than that in the control group. The serum CysC level in early onset patients was lower than that in late onset patients (P 0.05). In Parkinson's disease patients, the serum levels of Hcyrrhium were positively correlated with age (P < 0.05). The serum CysC levels in patients with early onset were significantly lower than those in patients with late onset. There was a negative correlation between TG and age (r = -0.203, P = 0.05, r = 0.199, P 0.05), and a negative correlation between serum Hcy levels and age, and a negative correlation between serum CysC levels and age, and a negative correlation between serum CysC levels and age (r = -0.203, P 0.05, P 0.05) in patients with Parkinson's disease, and in patients with Parkinson's disease, with a positive correlation between serum Hcy levels and age. The score was positively correlated with the course of disease 0.436m P0.05, the equivalent dose of levodopa was 0.424P0.05). The area under the ROC curve of serum ApoB for diagnosis of Parkinson's disease was 0.341 and P0.05, which had no diagnostic value for Parkinson's disease. The area under the ROC curve of serum HDL-C for the diagnosis of Parkinson's disease is 0.588U P0.05, which is of low diagnostic value for Parkinson's disease. The corresponding limit value of HDL-C is 1.135 mmol / L, the diagnostic sensitivity is 60.2 and the specificity is 53.3. The area under the ROC curve of serum Hcy for diagnosis of Parkinson's disease is 0.643 渭 mol / L, which is of low diagnostic value for Parkinson's disease. The corresponding threshold value of Hcy was 16.5 渭 mol / L, the diagnostic sensitivity was 60.2 渭 mol / L, the specificity was 65.4. Conclusion: the low serum TCG level and the high HDL-Cy CysC level may be associated with the occurrence and development of Parkinson's disease, and the decrease of serum ApoB level and the increase of HDL-CHcy level are independent risk factors for Parkinson's disease. There may be differences in the pathogenesis between early and late Parkinson's disease.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5

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