血清维生素D水平与帕金森病患者交感皮肤反应的临床研究

doi:10.19854/j.cnki.1008-2425.2024.03.0002

摘要/Abstract

摘要： 目的分析帕金森病(Parkinson's disease,PD)患者血清维生素D(Vitamin D,VitD)水平与交感皮肤反应(Sympathetic Skin Response,SSR)的相关性;探究血清VitD水平是否参与PD自主神经功能障碍发生发展。方法选取44例PD患者和年龄、性别匹配的51例健康体检者进行SSR检查、VitD检验和自主神经功能症状量表(The Scales for Outcomes in Parkinson' s Disease for Autonomic Symptoms,SCOPA-AUT)评分。通过病例对照研究的方法比较组间各指标差异。结果 1、与对照组相比,PD组患者四肢SSR波幅降低,左上肢和右下肢潜伏期延长,血清25(OH)D₂、25(OH)D₃及总25(OH)D水平均降低(P＜0.05)。2、SSR异常的PD患者中有86.7%血清总25(OH)D水平属缺乏组,较不足和正常组显著升高(P＜0.01)。3、PD患者SCOPA-AUT评分与SSR四肢潜伏期均呈正相关(r=0.245,P＜0.01;r=0.398,P＜0.01;r=0.353,P＜0.01;r=0.168,P＜0.01);与四肢波幅呈负相关(r=-0.434,P＜0.01;r=-0.341,P＜0.01;r=-0.367,P＜0.01;-0.289,P＜0.01)。4、PD患者H&Y分级、UPDRS-Ⅲ及SCOPA-AUT评分随总25(OH)D水平的降低而增高。三组间除右上肢波幅外,SSR其余肢体的波幅和四肢的潜伏期差异均无统计学意义(P＞0.05)。5、血清总25(OH)D与PD患者的H&Y分级、UPDRS-Ⅲ及SCOPA-AUT评分均呈显著负相关关系(r=-0.754,P＜0.01;r=-0.730,P＜0.01;r=-0.726,P＜0.01);与左下肢潜伏期及双下肢波幅无明显相关性(P＞0.05),与双上肢及右下肢潜伏期呈负相关(r=-0.319,P=0.035;r=-0.363,P=0.015;r=-0.355,P=0.018),与双上肢波幅呈正相关(r=0.381,P=0.011;r=0.342,P=0.023)。结论帕金森病患者的血清维生素D水平显著降低,交感皮肤反应异常的发生率增高。血清25(OH)D缺乏可能参与帕金森病自主神经症状发生发展的过程。

关键词: 帕金森病, 自主神经功能障碍, 血清维生素D, 交感皮肤反应

Abstract: Objective To investigate the relationship between serum Vitamin D(VitD) levels and Sympathetic Skin Response(SSR) in patients with Parkinson's disease(PD).To explore whether serum VitD level is involved in the occurrence and development of autonomic nervous dysfunction in PD.Methods 44 patients with PD and 51 healthy subjects matched by age and sex were selected for SSR examination,VitD test and The Scales for Outcomes in Parkinson's Disease for Autonomic function Symptoms,SCOPA-AUT) score.A case-control study was used to compare the differences among the groups.Results Compared with the control group,the SSR amplitude of limbs in PD group was decreased,the latency of left upper limb and right lower limb was prolonged,and the levels of serum 25(OH)D₂,25(OH)D₃ and total 25(OH)D were decreased(P＜0.05).2.The serum total 25(OH)D level in 86.7% of PD patients with SSR abnormality was in the deficient group,which was significantly higher than that in the deficient and normal groups(P＜0.01).3.The SCOPA-AUT score of PD patients was positively correlated with the limb latency of SSR(r=0.245,P＜0.01;r=0.398,P＜0.01;r=0.353,P＜0.01;r=0.168,P＜0.01);It was negatively correlated with limb amplitude(r=-0.434,P＜0.01;r=-0.341,P＜0.01;r=-0.367,P＜0.01;-0.289,P＜0.01).4.H&Y grading,UPDRS-Ⅲ and SCOPA-AUT scores of PD patients increased with the decrease of total 25(OH)D levels.Except for the right upper limb amplitude,there were no significant differences in the amplitude of the other limbs of SSR and the latency of the limbs among the three groups(P>0.05).5.Serum total 25(OH)D was significantly negatively correlated with the H&Y grade,UPDRS-Ⅲ and SCOPA-AUT scores of PD patients(r=-0.754,P＜0.01;r=-0.730,P＜0.01;r=-0.726,P＜0.01);There was no significant correlation with latency of left lower limb and amplitude of both lower limbs(P > 0.05),but negative correlation with latency of both upper limb and right lower limb(r=-0.319,P=0.035;r=-0.363,P=0.015;r=-0.355,P=0.018),was positively correlated with the amplitude of the double upper limbs(r=0.381,P=0.011;r=0.342,P=0.023).Conclusion The serum vitamin D level of Parkinson's disease patients decreased significantly,and the incidence of Sympathetic Skin Response abnormalities increased.Serum 25(OH)D deficiency may be involved in the development of autonomic symptoms in Parkinson's disease.

Key words: Parkinson's disease, Autonomic dysfunction, Serum vitamin D, Sympathetic skin response

中图分类号:

R742.5

赵海华, 蔡鸣. 血清维生素D水平与帕金森病患者交感皮肤反应的临床研究[J]. 立体定向和功能性神经外科杂志, 2024, 37(3): 134-140.

Haihua Zhao, Cai Ming. Clinical study of serum vitamin D level and sympathetic skin response in patients with Parkinson's disease[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2024, 37(3): 134-140.

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