首页|血清25-羟维生素D3水平对帕金森病伴脑小血管病患者认知障碍的预测价值

血清25-羟维生素D3水平对帕金森病伴脑小血管病患者认知障碍的预测价值

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目的:探讨血清25-羟维生素D3[25-(OH)D3]水平对帕金森病(PD)伴脑小血管病(CSVD)患者认知障碍的预测价值.方法:回顾性分析125 例PD伴CSVD患者的临床资料,所有患者均测定血清25-(OH)D3、胱抑素C(Cys-C)、同型半胱氨酸(Hcy)等指标,同时记录基线资料及MoCA评分.根据MoCA评分,将患者分为非认知障碍组(65 例)和认知障碍组(60 例).比较两组患者的一般资料,采用Logistic回归分析患者认知功能的影响因素,采用ROC曲线评估各指标对患者认知障碍的预测价值.结果:Cys-C(OR =4.714,95%CI为 2.456～9.047)是患者认知障碍的危险因素,受教育程度[高中及中专:OR =0.004,95%CI为 0.000～0.194;大专及以上:OR =0.002,95%CI为0.000～0.081]和25-(OH)D3(OR =0.237,95%CI为0.126～0.447)是患者认知功能的保护因素.血清25-(OH)D3 和Cys-C预测PD伴CSVD患者发生认知障碍的截断值分别为 10.38 μg/L和 0.96 mg/L.建立 25-(OH)D3 预测PD伴CSVD患者发生认知障碍的模型(AUC =0.934,95%CI为0.886～0.983,P<0.001),其敏感度86.7%,特异度98.5%.25-(OH)D3 模型预测 PD伴 CSVD患者认知障碍的 AUC大于 25-(OH)D3、Cys-C(P<0.001);而25-(OH)D3 与Cys-C的预测效果相似(P =0.129).结论:血清25-(OH)D3 水平可能会成为预测PD伴CSVD患者发生认知障碍的一种便捷的指标.
Predictive value of serum 25-hydroxyvitamin D3 level in evaluating cog-nitive impairment in patients with Parkinson's disease and cerebral small vessel disease
Aim:To evaluate the value of serum 25-hydroxyvitamin D3[25-(OH)D3]level in predicting cognitive im-pairment in patients with Parkinson's disease(PD)and cerebral small vessel disease(CSVD).Methods:A retrospective study was performed on 125 patients with PD and CSVD.Serum 25-(OH)D3,cystatin C(Cys-C),and homocysteine(Hcy)were measured.Baseline data and MoCA score were recorded.According to the MoCA score,the patients were divided into non-cognitive impairment group(65 cases)and cognitive impairment group(60 cases).The general data of 2 groups were compared.Logistic regression was used to analyze the influencing factors of cognitive impairment in patients with PD and CSVD.ROC curve was used to evaluate the predictive value of each index for cognitive impairment.Results:Cys-C(OR = 4.714,95%CI was 2.456-9.047)was a risk factor for cognitive impairment in patients,and education level(high school and vocational school:OR =0.004,95%CI was 0.000-0.194;college degree or above:OR =0.002,95%CI was 0.000-0.081)and 25-(OH)D3(OR =0.237,95%CI was 0.126-0.447)were protective factors.The cut-off values of serum 25-(OH)D3 and Cys-C for predicting cognitive impairment in patients with PD and CSVD,were 10.38 μg/L and 0.96 mg/L,respectively.A model based on 25-(OH)D3 was established to predict cognitive impairment in patients with PD and CSVD(AUC =0.934,95%CI was 0.886-0.983,P<0.001),the sensitivity was86.7%,and the specificity was98.5%.The AUC of 25-(OH)D3 model in predicting cognitive impairment in patients with PD and CSVD was significantly better than that of 25-(OH)D3 or Cys-C(P<0.001).The prediction effect of 25-(OH)D3 was consistent with Cys-C(P =0.129).Conclusion:Serum 25-(OH)D3 level may be a convenient index to predict the risk of cognitive impairment in patients with PD and CSVD.

Parkinson's diseasecerebral small vessel diseasecognitive impairment25-hydroxyvitamin D3

宋晓贇、杨改清、张晓艺

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新乡医学院三全学院病理学教研室 河南新乡 453003

郑州大学附属郑州中心医院神经内科 郑州 450007

帕金森病 脑小血管病 认知障碍 25-羟维生素D3

河南省医学科技攻关计划项目河南省医学科技攻关项目河南省高等学校重点科研项目

192102310082201802077720B320051

2024

10.13705/j.issn.1671-6825.2023.01.011

郑州大学学报(医学版)
郑州大学

郑州大学学报(医学版)

CSTPCD北大核心
影响因子：1.246
ISSN：1671-6825
年,卷(期)：2024.59(1)
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