[1]陈思远,刘银龙,古祺,等.颈部迷走神经横截面面积在帕金森病诊断中的价值[J].新乡医学院学报,2023,40(12):1131-1135.[doi:10.7683/xxyxyxb.2023.12.006]
　CHEN Siyuan,LIU Yinlong,GU Qi,et al.Value of cervical vagus cross-sectional area in diagnosis of Parkinson′s disease[J].Journal of Xinxiang Medical University,2023,40(12):1131-1135.[doi:10.7683/xxyxyxb.2023.12.006]
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颈部迷走神经横截面面积在帕金森病诊断中的价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年12
页码:
1131-1135
栏目:
临床研究
出版日期:
2023-12-05

文章信息/Info

Title:
Value of cervical vagus cross-sectional area in diagnosis of Parkinson′s disease
作者:
陈思远1; 刘银龙2; 古祺1; 朱丽敏2; 吴少璞1; 李东升1; 马建军1; 李学1
（1.郑州大学人民医院/河南省人民医院/河南大学人民医院神经内科，河南　郑州　450003；2.郑州大学人民医院/河南省人民医院/河南大学人民医院超声科，河南　郑州　450003）
Author(s):
CHEN Siyuan1; LIU Yinlong2; GU Qi1; ZHU Limin2; WU Shaopu1; LI Dongsheng1; MA Jianjun1; LI Xue1
（1.Department of Neurology,People′s Hospital of Zhengzhou University/Henan Provincial People′s Hospital/People′s Hospital of Henan University,Zhengzhou 450003,Henan Province,China;2.Department of Ultrasound,People′s Hospital of Zhengzhou University/Henan Provincial People′s Hospital/People′s Hospital of Henan University,Zhengzhou 450003,Henan Province,China)
关键词:
帕金森病; 多系统萎缩; 迷走神经; 横截面面积; 自主神经功能障碍
Keywords:
Parkinson′s disease; multiple system atrophy; vagus nerve; cross-sectional area; autonomic dysfunction
分类号:
R742.5
DOI:
10.7683/xxyxyxb.2023.12.006
文献标志码:
A
摘要:
目的　探讨颈部迷走神经横截面面积（CAS）对帕金森病（PD）的诊断价值。
方法　选择2019年10月至2022年10月郑州大学人民医院收治的30例PD患者为PD组，同期郑州大学人民医院收治的25例多系统萎缩（MSA）患者为MSA组，另选择同期于郑州大学人民医院体检健康者30人为健康对照组。采用高分辨率超声测量3组受试者的颈部迷走神经CAS，比较3组受试者颈部迷走神经CAS的差异；采用PD自主神经症状量表（SCOPA-AUT）评估3组受试者自主神经功能的受损程度，采用受试者操作特征（ROC）曲线分析颈部迷走神经CAS对PD的诊断价值。
结果　健康对照组、PD组受试者右侧颈部迷走神经CAS显著大于左侧（P<0.05）；MSA组受试者双侧颈部迷走神经CAS比较差异无统计学意义（P>0.05）。PD组、MSA组受试者双侧颈部迷走神经CAS及平均CAS均显著小于健康对照组（P<0.01）。MSA组受试者右侧颈部迷走神经CAS显著小于PD组（P<0.05）；MSA组受试者左侧颈部迷走神经CAS及平均CAS与PD组比较差异无统计学意义（P>0.05）。PD组、MSA组受试者SCOPA-AUT总分及胃肠道（GI）、心血管系统（CV）、泌尿系统（UR）、性功能（SX）评分显著高于健康对照组（P<0.01）。MSA组受试者的SCOPA-AUT总分及UR、SX评分显著高于PD组（P<0.05）。3组受试者的体温调节（TH）、瞳孔活动（PU）评分比较差异无统计学意义（P>0.05）。Pearson相关性分析显示，PD患者颈部迷走神经CAS与SCOPA-AUT总分及UR、TH、PU、SX评分均无相关性（r=-0.143、0.281、0.297、0.265、0.312，P>0.05），PD患者颈部迷走神经CAS与GI、CV评分呈负相关（r=-0.683、-0.373，P<0.05）。ROC曲线分析显示，颈部迷走神经诊断PD的曲线下面积为0.870（95%置信区间：0.773~0.966，P<0.05），临界值为3.064 mm2，敏感度为96%，特异度为67%；颈部迷走神经CAS鉴别PD、MSA的线下面积为0.680（95%置信区间：0.537~0.823，P<0.05）；当颈部迷走神经CAS<2.709 mm2时诊断MSA的敏感度为68%，特异度为70%。
结论　颈部迷走神经CAS对诊断PD具有较高的临床价值，为提高PD的诊断率提供了新的思路。
Abstract:
Objective　To investigate the diagnostic value of cervical vagus nerve cross-sectional area (CAS) for Parkinson′s disease(PD).
Methods　Thirty patients with PD admitted to the People′s Hospital of Zhengzhou University from October 2019 to October 2022 were selected as PD group,25 patients with multiple system atrophy(MSA) admitted to the People′s Hospital of Zhengzhou University during the same period were selected as the MSA group,and 30 healthy individuals who underwent physical examination in the People′s Hospital of Zhengzhou University during the same period were selected as healthy control group.Cervical vagus CAS of subjects in the three groups were measured by high-resolution ultrasound,and the difference of CAS of cervical vagus nerve was compared among the three groups.The degree of impairment of autonomic nervous function of subjects in the three groups was evaluated by PD autonomic symptom scale (SCOPA-AUT).The diagnostic value of cervical vagus nerve CAS for PD was analyzed by receiver operating characteristic(ROC) curve.
Results　The CAS of the right cervical vagus nerve of subjects was significantly larger than that of the left in the healthy control group and PD group (P<0.05);there was no significant difference in CAS of bilateral cervical vagus nerve of subjects in the MSA group(P>0.05).The CAS and average CAS of bilateral cervical vagus nerve of subjects in the PD group and MSA group were significantly lower than those in the healthy control group (P<0.01).The CAS of the right vagus nerve of subjects in the MSA group was significantly lower than that in the PD group(P<0.05);there was no significant difference in CAS and the average CAS of the left vagus nerve between the MSA group and the PD group (P>0.05).The total score of SCOPA-AUT and gastrointestinal(GI),cardiovascular(CV),urinary(UR) and sexual(SX) scores of subjects in the PD group and MSA group were significantly higher than those in the healthy control group (P<0.01).The total score of SCOPA-AUT and UR,SX scores of subjects in the MSA group were significantly higher than those in the PD group (P<0.05).There was no significant difference in temperature(TH) and pupil(PU) of subjects among the three groups (P>0.05).Pearson correlation analysis showed that the CAS of cervical vagus nerve of PD patients was not correlated with the total score of SCOPA-AUT and the UR,TH,PU,SX scores (r=-0.143,0.281,0.297,0.265,0.312;P>0.05).The CAS of cervical vagus nerve of PD patients was negatively correlated with GI and CV scores (r=-0.683,-0.373;P<0.05).ROC curve analysis showed that the area under the curve of cervical vagus nerve for diagnosing PD was 0.870 (95% confidence interval:0.773-0.966,P<0.05);the critical value was 3.064 mm2, the sensitivity was 96%,and the specificity was 67%.The area under the curve of CAS of cervical vagus nerve in differential diagnosis of PD,MSA was 0.680 (95% confidence interval:0.537-0.823,P<0.05).The sensitivity and specificity for the diagnosis of MSA were 68% and 70% when the CAS of the cervical vagus nerve <2.709 mm2.
Conclusion　The CAS of cervical vagal nerve has high clinical diagnostic value for PD,and it provides a new way to improve the diagnosis rate of PD.

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更新日期/Last Update: 2023-12-05