外周血全身免疫炎症指数、中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值与帕金森病认知功能障碍的相关性研究

目的探讨帕金森病( PD)病人认知功能障碍与外周血全身免疫炎症指数( SII)、中性粒细胞与淋巴细胞比值( NLR)和单核细胞与淋巴细胞比值(MLR)水平的相关性。方法选取 2017年 1月至 2022年 9月于淮安市第一人民医院就诊的 PD病人 93例为 PD组，并选择同期体检的健康人群 117例为对照组( HC组)，收集所有人的人口学资料和临床检查结果。另外 PD病人还需完成 Hoehn-Yahr分期( H-Y)、统一帕金森病评定量表第三部分( UPDRS Ⅲ)、蒙特利尔认知评估量表( MoCA)、生活质量量表( PDQ39)评估。根据 MoCA评分将 PD组分为 PD伴认知正常组( PD-NC)、 PD伴轻度认知功能障碍组( PD-MCI)和 PD伴痴呆组( PDD)，其中 PD-MCI组和 PDD组统称为 PD伴认知功能障碍组( PD-CI)进行三组间比较，分析 PD组 SII、NLR、MLR等临床指标与 MoCA评分有无相关性，进行二元 logistic回归分析寻找 PD病人出现认，知功能障碍的影响因素，并绘制诊断 PD病人伴认知功能障碍的受试者操作特征曲线( ROC曲线)。结果 PD组的淋巴细胞计数、血小板计数［1.49(1.23，1.83)×109/L、193(158，223)×109/L］低于 HC组［2.09(1.68，2.48)×109/L、206(172，245)×109/L］SII/100、NLR及 MLR高于 HC组(均 P<0.05)。 PD病人的 MoCA总分与淋巴细胞计数呈正相关，与 SII/100、NLR、UPDRS Ⅲ评分、P，DQ39评分及 H-Y分期呈负相关。 SII/100(OR=

A research study on the correlation between systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio in peripheral blood, and cognitive impairment in Parkinson''s disease

Objective To explore the correlation between cognitive dysfunction and peripheral blood systemic immune inflammationindex (SII), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR) levels in patients with Parkinson''s disease(PD).Methods Ninety-three PD patients who visited the Huai''an First People''s Hospital from January 2017 to September 2022 wereselected as the PD group, and 117 healthy people who underwent physical examination during the same period were selected as the control group (HC group). Demographic data and clinical examination results of all patients were collected. In addition, PD patients werealso required to complete Hoehn-Yahr staging (H-Y), Unified Parkinson''s Disease Rating Scale Part Ⅲ (UPDRS Ⅲ), Montreal Cognitive Assessment (MoCA), and Quality of Life Scale (PDQ39). According to the MoCA score, the PD group was assigned into PD withnormal cognition group (PD-NC), PD with mild cognitive impairment group (PD-MCI) and PD with dementia group (PDD), among which PD-MCI group and PDD group were collectively referred to as PD with cognitive impairment group (PD-CI). Comparison among the three groups was performed to analyze whether there was a correlation between clinical indicators such as SII, NLR and MLR in the PDgroup and MoCA score. Binary logistic regression analysis was performed to find out the influencing factors of cognitive impairment inPD patients, and ROC curve for diagnosis of cognitive impairment in PD patients was drawn.Results The lymphocyte count and platelet count [1.49 (1.23, 1.83)×109/L, 193 (158,223)×109/L] in the PD group were lower than those in the HC group [2.09 (1.68, 2.48)×109/L, 206 (172,245)]×109/L] (P<0.05). The SII/100, NLR, and MLR in the PD group were higher than those in the HC group (P<0.05). There were statistically significant differences in age, gender, smoking history, education years, lymphocyte count, H-Y stage, UPDRS Ⅲ score, and PDQ39 score among the PD, PD-MCI, and PD-NC groups. The total MoCA score of PD patients was positively correlatedwith lymphocyte count, and negatively correlated with SII/100, NLR, UPDRS Ⅲ score, PDQ39 score, and H-Y stage. SII/100 (OR= 1.21, P=0.030) and H-Y stage (OR=1.92, P=0.029) were risk factors for cognitive dysfunction in PD patients. The years of education (OR=0.82, P=0.004) was a protective factor for cognitive dysfunction in PD patients. ROC curve showed that the AUC of SII/100 in diagnosing PD patients with cognitive impairment was 0.64 [95%CI: (0.53, 0.75), P<0.001], the threshold was 7.19, the sensitivity was 40.38%, and the specificity was 90.24%.Conclusions SII and NLR in the peripheral blood of PD patients are negatively correlatedwith the level of cognitive function. The elevated level of SII is a risk factor for cognitive dysfunction in PD patients, and SII has a certain predictive value for cognitive dysfunction in PD patients.