Analysis Of Serum Biochemical Indexes And Transcranial Ultrasound In Patients With Motor Symptoms Lateralization Of Parkinsion’s Disease

Objective:To investigate the distribution characteristics of first-episode motor symptoms in Parkinson’s disease(PD)patients and make it clear whether there is difference among PD patients with different onset sides in serum biochemical indexes and transcranial sonography(TCS),this study explored the distribution characteristics with onset motor symptoms in the PD patients and analyzed the serum total protein(TP),albumin ALB),urea(UREA),uric acid(UA),creatinine(Cr),uric acid/creatinine(UA/Cr),glomerular filtration rate(GFR)and TCS with different onset sides in the PD patients.Methods:In this cross-sectional feasibility study,the 209 PD patients were collected who hospitalized in the Neurology Department of Hebei General Hospital from September 2016 to October 2020.All patients meet the Chinese diagnostic criteria for Parkinson’s disease(2016 version)and were recorded in terms of gender,age,age of onset,disease duration,side of onset,motor signs of onset,Hoehn-Yahr(H-Y)staging.According to the side of onset,these PD patients were divided into three groups including left-sided onset of symptoms in Parkinson’s disease(LPD)group,right-side onset of symptoms in Parkinson’s disease(RPD)group and bilateral-sided onset of symptoms in Parkinson’s disease(BPD)group.The epidemiological data,serum biochemical indexes and TCS results of these PD patients were retrospectively analyzed and compared by one-way ANOVA or KruskalWallis H test among the three groups,and Spearman correlation analysis was carried out for various indexes.Results:The 209 PD patients which including 125 males(59.8%)and 84females(40.2%).The average age was 66.70 years old.The age of onset was26～86(62.17±9.89)years old.The average disease duration was 4.53 years.And motor signs of onset in tremor had 130(62.2%),the bradykinesia had59(28.2%),the ankylosis had 20(9.6%).There was no significant difference in gender and disease duration among the three groups(P>0.05).In age and age of onset,there was no significant difference between LPD group and RPD group,RPD group and BPD group(P>0.05).LPD group was younger than BPD group,age of onset was earlier,the difference was statistically significant(P<0.05).There was no significant difference in onset form between LPD group and RPD group(P>0.05).LPD group and BPD group,RPD group and BPD group were no significant difference(P>0.05).LPD group and RPD group had more motor signs of onset in tremor,less in bradycardia and ankylosis,BPD group had more motor signs of onset in bradycardia,less in tremor and ankylosis.There was significant difference with H-Y staging among the three groups(P<0.05).There was no significant difference in H-Y staging between LPD group and RPD group(P>0.05),but there was significant difference in H-Y staging between LPD group and BPD group,RPD group and BPD group(P<0.05).And H-Y staging of BPD group was higher than LPD group or RPD group.There was no significant difference in the levels of serum total protein,albumin,urea,uric acid,creatinine,uric acid/creatinine and glomerular filtration rate among the three groups(P>0.05).The difference of TCS level among the three groups were no statistically significant(P>0.05).The difference of substantia nigra(SN)echogenic area among the three groups were statistically significant(P<0.05).The area of SN echogenic was larger on the right side in LPD patients,while that larger on the left side in RPD patients,and BPD had the equal SN echogenic area on both sides.Conclusions:1.PD mostly starts from one side,the form of asymmetry onset is usually tremor symptom,the form of bilateral-sided onset is usually bradykinesia symptom.The proportion of PD patients with left onset to right onset is roughly equal.There is no difference in side of onset between male and female patients.PD patients with left onset may be earlier than those with bilateral onset.2.There is no significant difference in serum total protein,albumin,urea,uric acid,creatinine,uric acid/creatinine and glomerular filtration rate between PD patients with different onset sides.3.In PDSN+ patients,the area of SN echogenic is larger on the right side in LPD patients,while that larger on the left side in RPD patients,and BPD has the equal SN echogenic area on both sides.4.It is difficult to predict the disease severity with onset side in PD patients.