Clinical application of transcranial substantia nigra ultrasound in patients with Parkinson's disease accompanied by hypoceruloplasminemia

doi:10.19854/j.cnki.1008-2425.2023.02.0002

Abstract

Abstract: Objective To analyze the clinical application value of transcranial substantia nigra ultrasound in patients with Parkinson's disease accompanied by hypoceruloplasminemia.Methods From January 2020 to July 2022,60 patients with Parkinson's disease with hypoceruloplasminemia were selected as group A.In addition,50 patients with Parkinson's disease matching group A in gender,age and disease course without hypoceruloplasminemia were selected as group B.All subjects underwent transcranial ultrasound examination of the substantia nigra to calculate the strong echo area of the substantia nigra (SN strong echo area) and the ratio of the substantia nigra strong echo area to the midbrain area (SM ratio),and analyze the relationship between the SN strong echo area and SM ratio of group A and the level of ceruloplenin and the score of the Unified Scale of Parkinson's Disease Part III (UPDRS-Ⅲ).ROC curve was used to analyze the diagnostic efficacy of SN echo area combined with SM ratio in Parkinson's disease with hypoceruloplasemia.Results The SN echo area and SM ratio of group A were higher than those of group B,the differences were statistically significant(P＜0.05).The plasma ceruloplasmin level in group A was lower than that in group B,and the UPDRS-Ⅲ score was higher than that in group B,with statistical significance(P＜0.05).By Pearson correlation analysis,the SN echo area and SM ratio of group A were negatively correlated with ceruloplasmin(P＜0.05),and positively correlated with UPDRS-Ⅲ score(P＜0.05).According to ROC curve analysis,the specificity,sensitivity and AUC of SN strong echo area combined with SM ratio in the diagnosis of Parkinson's disease with hypoceruloplasminemia were 67.94%,89.85% and 0.910.Conclusion The transcranial substantia nigra echo is enhanced in patients with Parkinson's disease complicated with hypoceruloplasminemia,the detection of SN strong echo area and SM ratio by transcranial substantia nigra ultrasound will be helpful for the diagnosis of Parkinson's disease complicated with hypoceruloplasminemia,which is worthy of clinical attention.

Key words: Parkinson's disease, Ceruloplasmin, Transcranial, Substantia nigra, Ultrasound, Midbrain

摘要： 目的分析经颅黑质超声在伴有低铜蓝蛋白血症帕金森病患者中的应用价值。方法选择我院自2022年5月至2023年3月接诊60例帕金森病合并低铜蓝蛋白血症患者作为A组,另外选择50例性别、年龄、病程与A组相匹配且不伴有低铜蓝蛋白血症的帕金森病患者作为B组。所有研究对象均进行经颅黑质超声检查,计算黑质强回声面积(SN强回声面积)、黑质强回声面积/中脑面积比值(SM比值),分析A组SN强回声面积、SM比值与铜蓝蛋白的水平、帕金森病统一评分量表第三部分(UPDRS-Ⅲ)评分的关系,使用ROC曲线分析SN强回声面积联合SM比值对帕金森病合并低铜蓝蛋白血症的诊断效能。结果 A组SN强回声面积、SM比值均大于B组,差异均有统计学意义(P＜0.05);A组血浆铜蓝蛋白水平低于B组,UPDRS-Ⅲ评分高于B组,差异均有统计学意义(P＜0.05);经Pearson相关性分析,A组SN强回声面积、SM比值与铜蓝蛋白呈负相关(P＜0.05),与UPDRS-Ⅲ评分均呈正相关(P＜0.05);经ROC曲线分析,SN强回声面积联合SM比值诊断伴有低铜蓝蛋白血症帕金森病的特异度为67.94%,敏感度为89.85%,AUC为0.910。结论合并低铜蓝蛋白血症的帕金森病患者的经颅黑质回声增强,检测SN强回声面积、SM比值的经颅黑质超声将有助于合并低铜蓝蛋白血症的帕金森病的诊断,值得临床予以重视应用。

关键词: 帕金森病, 铜蓝蛋白, 经颅, 黑质, 超声, 中脑

CLC Number:

R742.5

路英, 王霞. 经颅黑质超声在伴有低铜蓝蛋白血症帕金森病患者中的应用研究[J]. 立体定向和功能性神经外科杂志, 2023, 36(2): 71-75.

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