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目的探讨帕金森病患者认知功能和血尿酸水平的关系并对认知功能相关因素进行分析。方法入选PD患者78例和年龄、性别相匹配的40例健康对照组,记录PD患者的性别、年龄、病程、受教育年限、Hoehn&Yahr(H-Y)分级,采用蒙特利尔认知评估量表(Mo CA)对所有研究对象认知功能进行评估,对血尿酸、尿微量白蛋白水平进行检测。结果 PD组血尿酸水平明显低于健康对照组[(258.16±57.58)μmol/L比(330.23±52.92)μmol/L,P<0.01];早期PD组与中晚期PD组血尿酸水平无明显差异(P>0.05);但合并轻度认知功能障碍(MCI)的PD组血尿酸水平低于无MCI的PD组[(235.16±68.36)μmol/L比(272.58±59.69)μmol/L,P<0.01];各亚组间及各亚组与对照组比较尿微量白蛋白水平无明显差异(P>0.05);PD患者Mo CA评分与受教育年限(β=0.552,P<0.01)、血清尿酸水平(β=0.483,P<0.01)呈正相关,与病程(β=-0.469,P<0.05)、H-Y分级(β=-0.324,P<0.05)呈负相关。结论尿酸水平的改变可能参与了PD患者的发病机制;血尿酸水平下降可能是PD合并认知障碍的一个重要危险因素,对血尿酸水平进行适当干预可能有助于提高帕金森病患者的生活质量。
Objective To investigate the relationship between cognitive function and serum uric acid level in patients with Parkinson’s disease and to analyze the related factors of cognitive function. Methods A total of 78 patients with PD were enrolled in this study. Forty healthy controls matched with age and gender were enrolled in this study. Gender, age, course of disease, education duration, Hoehn & Yahr (HY) grade were recorded and assessed using Montreal Cognitive Assessment Scale (MoCA) All subjects were evaluated for cognitive function, and serum and urine microalbumin levels were measured. Results The level of serum uric acid in PD group was significantly lower than that in healthy control group [(258.16 ± 57.58) μmol / L vs 330.23 ± 52.92 μmol / L, P <0.01]. There was no significant difference in serum uric acid between PD group and PD group (P> 0.05). However, the serum uric acid level in PD group with mild cognitive impairment (MCI) was lower than that in PD group without MCI [(235.16 ± 68.36) μmol / L, <0.01]. There was no significant difference in urinary microalbuminuria between the subgroups and subgroups and the control group (P> 0.05). The Mo CA score of PD patients was significantly higher than that of the education years (β = 0.552, P <0.01) There was a positive correlation between uric acid level (β = 0.483, P <0.01) and negative correlation with disease course (β = -0.469, P <0.05) and HY grade (β = -0.324, P <0.05). Conclusions The change of uric acid level may be involved in the pathogenesis of PD. The decrease of serum uric acid level may be an important risk factor of PD complicated with cognitive impairment. Proper intervention of serum uric acid level may help to improve the quality of life of patients with Parkinson’s disease .