胱抑素C对血管性帕金森综合征的诊断效能

doi:10.3969/j.issn.1004-583X.2021.11.005

摘要/Abstract

摘要：

目的分析胱抑素C(Cys C)对血管性帕金森综合征(VP)的诊断效能。方法纳入2019年12月至2021年5月锦州市中心医院就诊的VP患者56例作为VP组,选择同期就诊的帕金森病(PD)患者51例作为PD组,另选择同期就诊的健康体检者50例作为健康对照组。分析一般临床资料、血清生化指标,分析血清Cys C及其他血清指标与VP的相关性,判断其对VP的辅助诊断价值。结果与PD组比较,甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)水平明显升高,且脑梗死、高血压、高脂血症患病率更高(P<0.05,P<0.01);与对照组比较,VP组血清Cys C、TG、LDL-C、Hcy水平明显升高,且脑梗死、高血压、糖尿病、高脂血症及冠心病患病率更高(P<0.05,P<0.01)。Logistic回归分析显示,年龄、脑梗死病史、Cys C、TG、LDL-C、Hcy是VP的危险因素(P<0.05,P<0.01)。ROC曲线分析显示, Cys C、TG、LDL-C、Hcy、Cys C+TG+LDL-C+Hcy在ROC曲线分析中对辅助诊断VP的AUC分别是0.764(95%CI:0.671~0.857,P=0.000)、0.801(95%CI:0.718~0.884,P=0.000)、0.751(95%CI:0.657~0.844,P=0.000)、0.723(95%CI:0.627~0.818,P=0.000)、0.920(95%CI:0.870~0.969,P=0.000)。结论血清CysC联合TG、LDL-C、Hcy水平可能对VP有潜在的辅助诊断及鉴别诊断价值。

关键词: 血管性帕金森综合征, 胱抑素C, 诊断效能

Abstract:

Objective To analyze the diagnostic efficacy of cystatin C(Cys C) for vascular Parkinsonism(VP). Methods Fifty-six inpatients with VP in Central Hospital of Jinzhou from December 2019 to May 2021 were included in VP group. In the same period, 51 inpatients with Parkinson's disease(PD) in PD group, and 50 healthy physical examiners at outpatient in healthy control group. The general clinical data and serum biochemical indexes were collected for analysis. The correlation between serum Cys C and other serum indexes in VP were compared and judged in auxiliary diagnostics. Results Compared with PD group, triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and homocysteine(Hcy) in VP group showed significantly increase, and the prevalence rates of cerebral infarction(CI), hypertension and hyperlipidemia were higher (P<0.05, P<0.01). Compared with control group, age, male, serum Cys C, TG, LDL-C and Hcy in VP group were significantly increased, and the prevalence rates of CI, hypertension, diabetes, hyperlipidemia and coronary heart disease(CHD) were higher,too(P<0.05, P<0.01). Logistic regression analysis showed that risks for VP were age, the history of CI, Cys C, TG, LDL-C and Hcy (P<0.05, P<0.01). ROC curve analysis showed that AUC of Cys C, TG, LDL-C, Hcy and Cys C+TG+LDL-C+Hcy in auxiliary diagnosis for VP were 0.764(95%CI:0.671-0.857, P=0.000), 0.801(95%CI: 0.718-0.884, P=0.000), 0.751(95%CI: 0.657-0.844, P=0.000), 0.723(95%CI: 0.627-0.818, P=0.000) and 0.920(95%CI: 0.870-0.969, P=0.000).Conclusion Serum Cys C combined with TG, LDL-C and Hcy may have potential auxiliary diagnosis and differential diagnostic value in VP.

Key words: vascular Parkinson's syndrome, cystatin C, diagnostic efficiency

中图分类号:

沈慧楠, 郭畅, 孙艺萌, 王东玉. 胱抑素C对血管性帕金森综合征的诊断效能[J]. 临床荟萃, 2021, 36(11): 986-990.

Shen Huinan, Guo Chang, Sun Yimeng, Wang Dongyu. Diagnostic efficacy of cystatin C for vascular Parkinsonism[J]. Clinical Focus, 2021, 36(11): 986-990.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.11.005

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I11/986

图/表 3

参考文献 35

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项目	VP组(n=56)	PD组(n=51)	健康对照组(n=50)	χ²值/F值	P值
年龄(岁)	71.29±4.97	64.25±4.31	63.80±4.19	46.476	<0.01
男性[例(%)]	42(75.00)	29(56.86)^*	28(56.00)	5.338	<0.05
脑梗死病史[例(%)]	41(73.21)	8(15.69)	0(0.00)	80.769	<0.01
高血压病史[例(%)]	18(32.14)	6(11.76)	0(0.00)^*	23.633	<0.05
糖尿病病史[例(%)]	12(21.43)	6(11.76)	0(0.00)^*	13.785	<0.05
高脂血症史[例(%)]	35(62.50)	16(31.37)^*	0(0.00)^*△	56.255	<0.01
冠心病病史[例(%)]	7(12.50)	3(5.88)	0(0.00)^△	7.070	<0.05
CysC(mmol/L)	1.54±0.75	0.99±0.39^*	0.71±0.18^*△	39.597	<0.05
TC (mmol/L)	4.76±1.02	4.42±1.14	4.36±1.12	2.144	>0.05
TG(mmol/L)	1.93±0.61	1.23±0.53	1.24±0.52	28.527	<0.01
HDL-C(mmol/L)	1.28±0.26	1.30±0.32	1.30±0.33	0.059	>0.05
LDL-C(mmol/L)	3.01±0.85	2.27±0.71	2.26±0.70	17.301	<0.01
Hcy(mmol/L)	17.90±6.01	13.41±4.10	12.64±3.21	20.751	<0.01
FBG(mmol/L)	5.55±0.76	5.35±0.63	5.32±0.48	1.429	>0.05
UA(μmmol/L)	311.59±70.61	295.22±62.76	295.24±63.39	1.112	>0.05

项目	VP组(n=56)	PD组(n=51)	健康对照组(n=50)	χ²值/F值	P值
年龄(岁)	71.29±4.97	64.25±4.31	63.80±4.19	46.476	<0.01
男性[例(%)]	42(75.00)	29(56.86)^*	28(56.00)	5.338	<0.05
脑梗死病史[例(%)]	41(73.21)	8(15.69)	0(0.00)	80.769	<0.01
高血压病史[例(%)]	18(32.14)	6(11.76)	0(0.00)^*	23.633	<0.05
糖尿病病史[例(%)]	12(21.43)	6(11.76)	0(0.00)^*	13.785	<0.05
高脂血症史[例(%)]	35(62.50)	16(31.37)^*	0(0.00)^*△	56.255	<0.01
冠心病病史[例(%)]	7(12.50)	3(5.88)	0(0.00)^△	7.070	<0.05
CysC(mmol/L)	1.54±0.75	0.99±0.39^*	0.71±0.18^*△	39.597	<0.05
TC (mmol/L)	4.76±1.02	4.42±1.14	4.36±1.12	2.144	>0.05
TG(mmol/L)	1.93±0.61	1.23±0.53	1.24±0.52	28.527	<0.01
HDL-C(mmol/L)	1.28±0.26	1.30±0.32	1.30±0.33	0.059	>0.05
LDL-C(mmol/L)	3.01±0.85	2.27±0.71	2.26±0.70	17.301	<0.01
Hcy(mmol/L)	17.90±6.01	13.41±4.10	12.64±3.21	20.751	<0.01
FBG(mmol/L)	5.55±0.76	5.35±0.63	5.32±0.48	1.429	>0.05
UA(μmmol/L)	311.59±70.61	295.22±62.76	295.24±63.39	1.112	>0.05

影响因素	回归系数	标准误	Wald χ²值	OR值	P值	95%CI
影响因素	回归系数	标准误	Wald χ²值	OR值	P值	下限	上限
年龄	0.685	0.217	9.976	1.984	0.002	1.297	3.034
脑梗死病史	3.002	1.269	5.600	1.050	0.018	0.004	0.597
Cys C	3.184	1.135	5.869	1.154	0.015	1.837	3.622
TG	3.807	1.458	6.819	1.107	0.009	2.585	4.092
LDL-C	2.754	1.036	7.060	1.699	0.008	2.059	2.678
Hcy	0.431	0.192	5.023	1.538	0.025	1.056	2.241

影响因素	回归系数	标准误	Wald χ²值	OR值	P值	95%CI
影响因素	回归系数	标准误	Wald χ²值	OR值	P值	下限	上限
年龄	0.685	0.217	9.976	1.984	0.002	1.297	3.034
脑梗死病史	3.002	1.269	5.600	1.050	0.018	0.004	0.597
Cys C	3.184	1.135	5.869	1.154	0.015	1.837	3.622
TG	3.807	1.458	6.819	1.107	0.009	2.585	4.092
LDL-C	2.754	1.036	7.060	1.699	0.008	2.059	2.678
Hcy	0.431	0.192	5.023	1.538	0.025	1.056	2.241

项目	AUC	敏感性	特异性	约登指数	临界值	P值	95%CI
项目	AUC	敏感性	特异性	约登指数	临界值	P值	下限	上限
年龄	0.845	0.679	0.961	0.64	68.5	0.000	0.772	0.918
Cys C+TG+LDL-C+Hcy	0.920	0.964	0.706	0.67	-	0.000	0.870	0.969
TG	0.801	0.607	0.902	0.509	1.82	0.000	0.718	0.884
LDL-C	0.751	0.732	0.765	0.497	2.565	0.000	0.657	0.844
Hcy	0.723	0.75	0.627	0.377	14.945	0.000	0.627	0.818
Cys C	0.764	0.696	0.804	0.5	1.29	0.000	0.671	0.857