血清胆红素水平与帕金森病临床症状的相关性研究

王恒杰; 朱啸巍; 季杜欣; 陈岩; 张超; 刘时华; 钟平; 曹立

doi:10.16766/j.cnki.issn.1674-4152.004079

血清胆红素水平与帕金森病临床症状的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.004079

王恒杰¹,
朱啸巍¹,
季杜欣¹,
陈岩¹,
张超¹,
刘时华¹,
钟平¹,
曹立^{1, 2, ,}

1.
安徽医科大学附属宿州医院神经内科，安徽宿州 234000
2.
上海交通大学医学院附属第六人民医院神经内科，上海 200233

基金项目:

安徽省临床医学研究转化专项项目 202204295107020063

安徽省卫生健康科研项目 AHWJ2022b106

详细信息

通讯作者:
曹立，E-mail：caoli2000@yeah.net

中图分类号: R742.5
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- 文章访问数: 8
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- 被引次数: 0
出版历程
- 收稿日期: 2024-09-19
- 网络出版日期: 2025-10-25

Correlation between serum bilirubin levels and motor symptoms in Parkinson' s disease

1.
Department of Neurology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, Anhui 234000, China

摘要

摘要: 目的探究血清胆红素(BI)水平与帕金森病(PD)临床症状(运动症状、非运动症状)的关系，为揭示PD发病机制及寻找潜在的生物学标志物提供理论依据。方法回顾性分析2021年7月—2024年7月于安徽医科大学附属宿州医院就诊的102例PD患者和102例健康体检者(HC)的临床资料。PD患者根据Hoehn-Yahr分期分为早期组(65例)和中晚期组(37例)。比较PD组和HC组、早期组和中晚期组组间总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平，分析血清BI水平与PD患者年龄、运动症状[帕金森病统一评分量表(UPDRS)-Ⅲ评分、Berg平衡量表]和非运动症状(蒙特利尔认知评估量表、汉密尔顿抑郁量表)的相关性。结果 102例PD组患者中，男性50例，女性52例，年龄为71(64，76)岁。PD组TBIL、DBIL均高于HC组(P < 0.05)。中晚期组TBIL[(16.04±6.73)μmol/L vs. (13.41±4.07)μmol/L, P=0.035]、IBIL[(11.01±5.05)μmol/L vs. (9.16±2.73)μmol/L, P=0.045]水平均高于早期组。Spearman相关分析显示，PD患者的运动症状严重程度(UPDRS-Ⅲ评分)与DBIL(r_s=0.325，P < 0.001)水平呈正相关关系。结论与健康体检者比较，PD患者的血清DBIL水平明显升高，且与PD运动症状呈正相关关系，通过检测和降低血清DBIL水平等可能对延缓PD运动症状进展有一定的作用。
- 帕金森病 /
- 运动症状 /
- 胆红素 /
- 总胆红素 /
- 直接胆红素 /
- 间接胆红素
Abstract: Objective To investigate the relationship between serum bilirubin levels and clinical symptoms (motor and non-motor symptoms) of Parkinson' s disease (PD), and to provide a theoretical basis for unraveling the pathogenesis of PD and searching for potential biological markers. Methods A retrospective analysis was conducted on clinical data from 102 PD patients and 102 healthy controls (HC) treated at Suzhou Hospital of Anhui Medical University between July 2021 and July 2024. The PD patients were divided into the early-stage group (65 patients) and the moderate-late-stage group (37 patients) according to Hoehn-Yahr staging. The levels of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) were compared between the PD and HC groups, as well as between the early- and middle-late-stage groups. In addition, the relationships between serum bilirubin levels and the age of the PD patients, motor symptoms [unified Parkinson' s disease rating scale (UPDRS)-Ⅲ scores, Berg balance scale] and non-motor symptoms (Montreal cognitive assessment scale, Hamilton depression scale) were analyzed. Results Among the 102 patients with PD (50 males and 52 females), the median age was [71 (64, 76)] years. Compared with the HC group, the PD group had significantly higher serum TBIL and DBIL (P < 0.05). The levels of TBIL [(16.04±6.73) μmol/L vs. (13.41±4.07) μmol/L, P=0.035] and IBIL [(11.01±5.05) μmol/L vs. (9.16±2.73) μmol/L, P=0.045] in the moderate-late-stage group were higher than those in the early-stage group. In PD patients, Spearman correlation analysis showed that the severity of motor symptoms (UPDRS-Ⅲ score) was positively correlated with DBIL (r_s=0.325, P < 0.001). Conclusion The serum levels of TBIL and DBIL in PD patients were significantly increased compared to healthy controls and were correlated with motor symptoms. DBIL may serve as a potential biomarker for assessing disease progression of PD.
- Parkinson' s disease /
- Motor symptoms /
- Bilirubin /
- Total bilirubin /
- Direct bilirubin /
- Indirect bilirubin

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表 1 PD组与HC组研究对象一般资料及血清BI水平比较

Table 1. Comparison of general data and serum BI levels between PD group and HC group

组别	例数	性别[例(%)]		年龄 [M(P₂₅, P₇₅), 岁]	有吸烟史 [例(%)]	有饮酒史 [例(%)]	有糖尿病史 [例(%)]	有高血压病史 [例(%)]	TBIL [M(P₂₅, P₇₅), μmol/L]	DBIL [M(P₂₅, P₇₅), μmol/L]	IBIL [M(P₂₅, P₇₅), μmol/L]
组别	例数	男性	女性	年龄 [M(P₂₅, P₇₅), 岁]	有吸烟史 [例(%)]	有饮酒史 [例(%)]	有糖尿病史 [例(%)]	有高血压病史 [例(%)]	TBIL [M(P₂₅, P₇₅), μmol/L]	DBIL [M(P₂₅, P₇₅), μmol/L]	IBIL [M(P₂₅, P₇₅), μmol/L]
PD组	102	50(49.02)	52(50.98)	71(64, 76)	9(8.82)	3(2.94)	22(21.57)	50(49.02)	13.65(10.80, 16.90)	4.20(2.90, 5.40)	9.35(7.20, 11.90)
HC组	102	44(43.14)	58(56.86)	69(65, 73)	7(6.86)	8(7.84)	28(27.45)	44(43.14)	12.05(9.90, 14.90)	3.30(2.70, 4.00)	8.80(7.10, 11.10)
统计量		0.710^a		-1.651^b	0.271^a	2.402^a	0.954^a	0.710^a	-2.498^b	-4.484^b	-1.083^b
P值		0.399		0.099	0.602	0.121	0.329	0.399	0.012	< 0.001	0.279
注：^a为χ²值，^b为Z值。

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表 2 早期组与中晚期组PD患者血清BI水平比较(μmol/L)

Table 2. Comparison of serum BI levels (μmol/L) between early PD and moderate-to-late PD groups (μmol/L)

组别	例数	TBIL(x±s)	DBIL[M(P₂₅, P₇₅)]	IBIL(x±s)
早期组	65	13.41±4.07	4.10(2.80, 4.90)	9.16±2.73
中晚期组	37	16.04±6.73	4.50(3.30, 6.20)	11.01±5.05
统计量		2.166^a	-1.856^b	2.062^a
P值		0.035	0.063	0.045
注：^a为t值，^b为Z值。

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表 3 血清BI水平与年龄及各量表评分的相关性分析

Table 3. Correlation analysis of serum BI levels with age and various scale scores

项目	TBIL		DBIL		IBIL
项目	统计量	P值	统计量	P值	统计量	P值
年龄	0.139^a	0.162	0.181^a	0.068	0.135^a	0.175
UPDRS-Ⅲ评分	0.280^a	0.004	0.325^a	< 0.001	0.248^b	0.012
MoCA评分	-0.066^a	0.513	-0.003^a	0.973	-0.167^b	0.094
HAMD评分	-0.061^a	0.539	-0.082^a	0.412	-0.044^a	0.660
BBS评分	-0.225^a	0.023	-0.263^a	0.008	-0.201^a	0.042
注：^a为r_s值，^b为r值。

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