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中华老年病研究电子杂志

中华老年病研究电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 14 -19. doi: 10.3877/cma.j.issn.2095-8757.2023.01.003

临床研究

C反应蛋白与白蛋白比值和中性粒细胞与淋巴细胞比值对老年帕金森病的诊断价值
韩远远, 于紫涵, 杨玲, 程弘禹, 宋春杰†()   
  1. 223800　江苏省宿迁市第一人民医院神经内科
  • 收稿日期:2022-08-01 出版日期:2023-02-28
  • 通信作者: 宋春杰

Diagnostic nalue of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio for Parkinson's disease in elderly patients

Yuanyuan Han, Zihan Yu, Ling Yang, Hongyu Cheng, Chunjie Song†()   

  1. Department of Neurology, The Affiliated Suqian First Hospital of Nanjing Medical University, Suqian 223800, China
  • Received:2022-08-01 Published:2023-02-28
  • Corresponding author: Chunjie Song
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韩远远, 于紫涵, 杨玲, 程弘禹, 宋春杰. C反应蛋白与白蛋白比值和中性粒细胞与淋巴细胞比值对老年帕金森病的诊断价值[J]. 中华老年病研究电子杂志, 2023, 10(01): 14-19.

Yuanyuan Han, Zihan Yu, Ling Yang, Hongyu Cheng, Chunjie Song. Diagnostic nalue of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio for Parkinson's disease in elderly patients[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(01): 14-19.

目的

探讨C反应蛋白与白蛋白比值（CAR）和中性粒细胞与淋巴细胞比值（NLR）对老年帕金森病（PD）的诊断价值。

方法

选取2019年1月至2022年3月在宿迁市第一人民医院就诊的老年PD患者87例（PD组）及因头痛头晕来院检查者60名（对照组），收集两组患者的基本资料、血生化指标，计算CAR和NLR。采用Spearman相关性分析CAR和NLR与PD患者疾病严重程度（Hoehn-Yahr分期）和认知功能障碍的相关性；采用多因素Logistic回归分析确定CAR和NLR是否为PD发病的危险因素；利用受试者工作特征（ROC）曲线评估CAR和NLR对PD的诊断价值。

结果

与对照组相比，PD组患者CAR和NLR水平明显增高，差异具有统计学意义（t=3.875、3.212，均P<0.01）。Spearman相关性分析结果显示，CAR与PD患者Hoehn-Yahr分期及认知功能障碍均呈正相关（r=0.614和0.712，P<0.01），NLR仅与PD患者认知功能障碍呈正相关（r=0.735，P<0.01）。多因素Logistic回归分析结果显示，CAR和NLR是PD的独立危险因素（OR=2.533、1.736，95%CI：1.662~4.064、1.437~2.968，P<0.01）。ROC曲线分析结果显示，CAR和NLR预测PD的曲线下面积分别为0.749（95%CI：0.666~0.831，P<0.05）和0.751（95%CI：0.670~0.833，P<0.05），CAR和NLR联合预测PD的曲线下面积为0.837（95%CI：0.772~0.903，P<0.01）。

结论

CAR和NLR与PD的发病风险、疾病严重程度和认知功能障碍相关，可作为诊断PD的生物学标志物，两者联合诊断的价值更高。

关键词: C反应蛋白, 白蛋白, 中性粒细胞, 淋巴细胞, 帕金森病
Objective

To explore the diagnostic nalue of of C-reactive protein to albumin ratio (CAR) and neutrophil to lymphocyte ratio (NLR) for Parkinson's disease (PD) in elderly patients.

Methords

A total of 87 elderly PD patients (PD group) and 60 patients with headache and dizziness (Control group) were collected from Suqian First Hospital from January 2019 to March 2022. Basic data and blood biochemical indexes of patients in the two groups were collected, and CAR and NLR were calculated. Spearman correlation analysis was used to analyze the correlation of CAR and NLR with disease severity (Hoehn-Yahr stage) and cognitive dysfunction in PD patients. Multivariate logistic regression analysis was used to determine whether CAR and NLR were risk factors for PD. The diagnostic value of CAR and NLR for PD was evaluated using receiver operating characteristic (ROC) curve .

Results

Compared with the control group, the levels of CAR and NLR in PD group were significantly higher, and the difference was statistically significant (t=3.875, 3.212; P < 0.05). Spearman correlation analysis showed that CAR was positively correlated with Hoehn-Yahr stage and cognitive dysfunction in PD patients (r=0.614, 0.712; P < 0.01), while NLR was only positively correlated with cognitive dysfunction in PD patients (r=0.735, P < 0.01). Multivariate Logistic regression analysis showed that CAR and NLR were independent risk factors for PD (OR=2.533, 1.736; 95%CI: 1.662-4.064, 1.437-2.968; P < 0.01). ROC curve analysis results showed that the areas under the curve predicted by CAR and NLR were 0.749 (95%CI: 0.666-0.831, P < 0.05) and 0.751 (95%CI: 0.670-0.833, P < 0.05), respectively. The area under the curve predicted by CAR and NLR was 0.837(95%CI: 0.772-0.903, P < 0.01).

Conclusion

CAR and NLR are associated with the risk, severity and cognitive dysfunction of PD, and can be used as biomarkers to diagnose PD, and their combined diagnostic value is higher.

Key words: C-reactive protein, Albumin, Neutrophil, Lymphocyte, Parkinson's disease
表1 两组患者基线资料的比较[例（%）或±s]
组别 例数 男性 年龄（岁） BMI（kg/m2） 吸烟 高血压 糖尿病 冠心病史 CRP（mg/L）
PD组 87 52（60.0） 70.7±8.3 23.26±2.41 22（25.3） 12（13.8） 13（14.9） 6（6.9） 5.06±3.43
对照组 60 38（63.3） 68.4±10.7 23.69±1.85 17（28.3） 10（16.7） 11（18.3） 6（10.0） 2.21±2.05
检验值   χ2=0.190 t=0.416 t=0.574 χ2=0.169 χ2=0.230 χ2=0.299 χ2=0.456 t=3.379
P值   >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 <0.01
组别 例数 受教育程度 白蛋白（g/L） 中性粒细胞（×109/L） 淋巴细胞（×109/L） CAR NLR
小学及以下 中学 大专及以上
PD组 87 19（21.8） 42（48.3） 26（29.9） 34.62±5.01 3.37±1.12 1.32±0.86 0.18±0.12 2.97±0.94
对照组 60 15（25.0） 26（43.3） 19（31.7） 39.45±4.37 2.12±1.03 2.07±0.42 0.08±0.07 1.98±1.06
检验值   χ2=0.653 t=1.267 t=2.824 t=2.366 t=3.875 t=3.212
P值   >0.05 <0.01 <0.01 <0.01 <0.01 <0.01
表2 不同Hoehn-Yahr分期老年帕金森病患者CAR和NLR的比较（±s）
Hoehn-Yahr分期 例数 CAR NLR
早期 22 0.11±0.09 2.75±1.09
中期 36 0.17±0.07 2.91±0.75
晚期 29 0.24±0.07 3.16±0.84
F值   8.372 0.781
P值   <0.01 >0.05
表3 伴或不伴认知功能障碍老年帕金森病患者CAR和NLR的比较（±s）
组别 例数 CAR NLR
伴认知功能障碍 54 0.23±0.09 3.13±0.59
不伴认知功能障碍 33 0.14±0.12 2.67±0.64
t值   2.376 1.615
P值   <0.01 <0.01
表4 老年帕金森病多因素Logistic回归分析
变量 回归系数 标准误 Wald值 OR值 95%CI P值
CAR 1.043 0.462 5.372 2.533 1.662~4.064 <0.01
NLR 0.716 0.289 8.264 1.736 1.437~2.968 <0.01
图1 CAR和NLR诊断老年帕金森病的ROC曲线注：CAR指C反应蛋白与白蛋白比值；NLR指中性粒细胞与淋巴细胞比值；ROC曲线指受试者工作特征曲线
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