血尿酸水平与初诊帕金森病轻度认知功能障碍相关性研究
发布时间：2018-09-06 19:19
【摘要】：目的探究血尿酸(uric acid,UA)水平与初诊帕金森病(Parkinson's disease,PD)患者轻度认知功能障碍的相关性。方法1.选取于我院神经科第一次就诊并且未进行任何抗PD治疗的80名PD患者(43名男性和37名女性)作为此项研究的观察组,以上患者行Hoehn-Yahr分级(H-Y分级)≤3.0级并且无痴呆临床表现。随机选取同时期于我院体检的70名个体(35名男性和35名女性)作为对照组。2.分别测定观察组及对照组个体的清晨空腹血UA及肌酐(Serum creatinine,SCr)浓度。3.根据H-Y分级将观察组患者分为PD早期组和PD中期组。其中,PD早期组患者46例,包括24名男性和22名女性;PD中期组患者34例,包括19名男性和15名女性。4.根据帕金森病轻度认知功能障碍(mild cognitive impairment,PD-MCI)诊断标准将PD患者分为无认知功能障碍组(no cognitive impairment,PD-NCI)及PD-MCI组。其中,PD-NCI组患者48例,包括26名男性和22名女性;PD-MCI组患者32例,包括17名男性和15名女性。5.所有统计分析使用SPSS版本17.0进行。结果1.一般临床资料的比较:观察组与对照组个体的年龄、女性比例、教育年限、SCr、体重指数(body mass index,BMI)等数据相比较,差异无统计学意义(P0.05);血UA、蒙特利尔认知评估量表(Motreal cognitive assess ment,MoCA)(中文版)分值相比较,差异具有统计学意义(P0.05)。2.PD-MCI组、PD-NCI组及对照组个体的SCr浓度相比较,差异无统计学意义(P0.05);PD-MCI组、PD-NCI组的血UA浓度均低于对照组,PD-MCI组血UA浓度低于PD-NCI组,以上差异均具有统计学意义(P0.05)。3.对于女性个体,PD-MCI组、PD-NCI组血UA浓度均低于对照组,PD-MCI组血UA浓度低于PD-NCI组,以上差异均具有统计学意义(P0.05);对于男性个体,PD-MCI组、PD-NCI组血UA浓度均低于对照组,PD-MCI组血UA浓度低于PD-NCI组,以上差异均具有统计学意义(P0.05);PD-MCI组、PD-NCI组、对照组各组之间男女个体的血UA浓度比较,差异无统计学意义(P0.05)。4.针对PD-MCI组患者的研究:PD早期组、中期组MoCA分值均低于对照组,PD早期组MoCA分值高于PD中期组,差异均具有统计学意义(P0.05);PD早期组、中期组UA浓度均低于对照组,差异均具有统计学意义(P0.05);PD早期组、中期组的血UA浓度相比较,差异无统计学意义(P0.05)。5.针对PD-NCI组患者的研究:PD早期组、中期组MoCA分值均低于对照组,PD早期组MoCA分值高于PD中期组,差异均具有统计学意义(P0.05);PD早期组、中期组UA浓度均低于对照组,差异均具有统计学意义(P0.05);PD早期组、中期组的血UA浓度相比较,差异无统计学意义(P0.05)。6.血UA浓度与PD患者MoCA量表中的命名能力具有正相关性,与其余认知领域无明显相关性。结论1.PD患者较健康个体的血UA水平降低,并且伴有轻度认知功能障碍PD患者较认知功能正常PD患者的血UA水平会进一步降低,这一结论对男女患者均适用。2.对于非痴呆PD患者来说,PD中期患者较PD早期的认知功能评分低,血UA水平较健康个体的低,但所处不同分期患者的血UA水平无明显差异。3.血UA浓度与PD患者MoCA量表中的命名能力具有正相关性,与其余认知领域无明显相关性。4.血UA浓度的降低可能是PD的发生及其认知功能下降的机制之一。
[Abstract]:Objective To explore the relationship between serum uric acid (UA) and mild cognitive impairment in newly diagnosed Parkinson's disease (PD) patients. Methods 1. 80 PD patients (43 men and 37 women) who were first treated in our department of Neurology and had not received any anti-PD treatment were selected as the observation group of this study. The ehn-Yahr grading (H-Y grading) was less than 3.0 and no clinical manifestations of dementia were observed. Seventy individuals (35 males and 35 females) were randomly selected as control group. 2. The UA and serum creatinine (SCr) concentrations in the morning fasting blood of the observation group and the control group were measured. 3. Patients in the observation group were divided into PD groups according to H-Y grading. There were 46 patients in the early PD group, including 24 males and 22 females; 34 patients in the middle PD group, including 19 males and 15 females. 4. According to the diagnostic criteria of mild cognitive impairment (PD-MCI), PD patients were divided into the non-cognitive impairment group (PD-MCI). Among them, 48 patients in the PD-NCI group, including 26 males and 22 females, 32 patients in the PD-MCI group, including 17 males and 15 females. Mass index, BMI and other data, there was no significant difference (P 0.05); blood UA, Montreal Cognitive Assessment (MoCA) (Chinese version) score, the difference was statistically significant (P 0.05). 2. PD-MCI group, PD-NCI group and the control group of individual SCR concentration, there was no significant difference (P 0.05); The serum UA concentration of PD-MCI group was lower than that of PD-NCI group. The above differences were statistically significant (P 0.05). 3. For female individuals, PD-MCI group and PD-NCI group, the serum UA concentration of PD-MCI group was lower than that of control group, and the serum UA concentration of PD-MCI group was lower than that of PD-NCI group, the above differences were statistically significant (P 0.05). The concentration of UA in CI group, PD-NCI group was lower than that in control group, and the concentration of UA in PD-MCI group was lower than that in PD-NCI group, the difference was statistically significant (P 0.05). There was no significant difference in the concentration of UA between male and female in PD-MCI group, PD-NCI group and control group (P 0.05). 4. Compared with the control group, the MoCA score of early PD group was higher than that of middle PD group, and the difference was statistically significant (P 0.05); UA concentration of early PD group and middle PD group was lower than that of the control group, the difference was statistically significant (P 0.05); UA concentration of early PD group and middle PD group was not statistically significant (P 0.05). The scores of MoCA in early PD group were significantly higher than those in middle PD group (P 0.05). The concentrations of UA in early PD group and middle PD group were significantly lower than those in control group (P 0.05). The concentrations of UA in early PD group and middle PD group were significantly lower than those in control group (P 0.05). Conclusion 1. The UA level of PD patients is lower than that of healthy individuals, and the UA level of PD patients with mild cognitive impairment is lower than that of PD patients with normal cognitive function. This conclusion is applicable to both male and female patients. For non-dementia PD patients, the cognitive function score in the middle stage of PD is lower than that in the early stage of PD, and the level of UA in blood is lower than that in healthy individuals, but there is no significant difference in the level of UA in different stages. 3. The concentration of UA in blood is positively correlated with the nomenclature ability of MoCA scale in PD patients, and has no significant correlation with other cognitive domains. It may be one of the mechanisms of the occurrence of PD and its cognitive decline.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5
本文编号：2227289
[Abstract]:Objective To explore the relationship between serum uric acid (UA) and mild cognitive impairment in newly diagnosed Parkinson's disease (PD) patients. Methods 1. 80 PD patients (43 men and 37 women) who were first treated in our department of Neurology and had not received any anti-PD treatment were selected as the observation group of this study. The ehn-Yahr grading (H-Y grading) was less than 3.0 and no clinical manifestations of dementia were observed. Seventy individuals (35 males and 35 females) were randomly selected as control group. 2. The UA and serum creatinine (SCr) concentrations in the morning fasting blood of the observation group and the control group were measured. 3. Patients in the observation group were divided into PD groups according to H-Y grading. There were 46 patients in the early PD group, including 24 males and 22 females; 34 patients in the middle PD group, including 19 males and 15 females. 4. According to the diagnostic criteria of mild cognitive impairment (PD-MCI), PD patients were divided into the non-cognitive impairment group (PD-MCI). Among them, 48 patients in the PD-NCI group, including 26 males and 22 females, 32 patients in the PD-MCI group, including 17 males and 15 females. Mass index, BMI and other data, there was no significant difference (P 0.05); blood UA, Montreal Cognitive Assessment (MoCA) (Chinese version) score, the difference was statistically significant (P 0.05). 2. PD-MCI group, PD-NCI group and the control group of individual SCR concentration, there was no significant difference (P 0.05); The serum UA concentration of PD-MCI group was lower than that of PD-NCI group. The above differences were statistically significant (P 0.05). 3. For female individuals, PD-MCI group and PD-NCI group, the serum UA concentration of PD-MCI group was lower than that of control group, and the serum UA concentration of PD-MCI group was lower than that of PD-NCI group, the above differences were statistically significant (P 0.05). The concentration of UA in CI group, PD-NCI group was lower than that in control group, and the concentration of UA in PD-MCI group was lower than that in PD-NCI group, the difference was statistically significant (P 0.05). There was no significant difference in the concentration of UA between male and female in PD-MCI group, PD-NCI group and control group (P 0.05). 4. Compared with the control group, the MoCA score of early PD group was higher than that of middle PD group, and the difference was statistically significant (P 0.05); UA concentration of early PD group and middle PD group was lower than that of the control group, the difference was statistically significant (P 0.05); UA concentration of early PD group and middle PD group was not statistically significant (P 0.05). The scores of MoCA in early PD group were significantly higher than those in middle PD group (P 0.05). The concentrations of UA in early PD group and middle PD group were significantly lower than those in control group (P 0.05). The concentrations of UA in early PD group and middle PD group were significantly lower than those in control group (P 0.05). Conclusion 1. The UA level of PD patients is lower than that of healthy individuals, and the UA level of PD patients with mild cognitive impairment is lower than that of PD patients with normal cognitive function. This conclusion is applicable to both male and female patients. For non-dementia PD patients, the cognitive function score in the middle stage of PD is lower than that in the early stage of PD, and the level of UA in blood is lower than that in healthy individuals, but there is no significant difference in the level of UA in different stages. 3. The concentration of UA in blood is positively correlated with the nomenclature ability of MoCA scale in PD patients, and has no significant correlation with other cognitive domains. It may be one of the mechanisms of the occurrence of PD and its cognitive decline.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5
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