Value of Blood Uric Acid Level and Transcranial Sonography of the Substantia Nigra for Parkinson's Disease

ZHANG Xiaoxiao; LI Feixiang; PENG Jiaxin; XIE Huan; LI Shiguang

doi:10.3969/j.issn.1004-437X.2026.16.006

Abstract：Objective To investigate the clinical value of blood uric acid combined with transcranial nigrostriatal ultrasound in the diagnosis of Parkinson's disease(PD).Methods A total of 50 patients with PD admitted to the First People's Hospital of Zhengzhou City from January 2023 to October 2024 and 50 healthy individuals in the same period were selected as the observation group and control group.The levels of blood uric acid were extracted from both groups,and transcranial nigrostriatal ultrasound was performed in both groups.And the differences between the hyperechoic substantia nigra area,the ratio of hyperechoic substantia nigra area to midbrain area(S/M),and blood uric acid level were compared.The correlation between the hyperechoic substantia nigra area,the S/M,and the blood uric acid level and different gradings in the PD group were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the value of transcranial nigrostriatal ultrasonography,blood uric acid level for PD diagnosis,and the clinical utility of the combination for PD diagnosis.Results The differences in the hyperechoic substantia nigra area,S/M,and the blood uric acid level were significant between the PD group and the control group(P＜0.05).In the control group,the hyperechoic substantia nigra area and the S/M were lower than those in the PD group,while the blood uric acid level in the control group was higher than that in the PD group(P＜0.05).Spearman analysis showed that among different Hoehn-Yahr stages in the observation group,the differences in the hyperechoic substantia nigra area and S/M were statistically significant(P＜0.05),whereas the difference in serum uric acid level was not statistically significant(P＞0.05).The hyperechoic substantia nigra area and S/M in the early-stage observation group were lower than those in the late-stage observation group(P＜0.05).The hyperechoic substantia nigra area and S/M were positively correlated with the Hoehn-Yahr stage,while serum uric acid level was negatively correlated with the Hoehn-Yahr stage.ROC curve analysis showed that the combination of serum uric acid and transcranial nigrostriatal ultrasound achieved an area under the curve(AUC)of 0.93(95％CI:0.88-0.98)in predicting the occurrence of PD,which was higher than that of serum uric acid alone,the hyperechoic substantia nigra area alone,and S/M alone.The optimal cut-off value was 0.484,with a sensitivity of 86％ and a specificity of 88％.Conclusion The hyperechoic substantia nigra area,S/M ratio,and blood uric acid levels have clinical significance in the diagnosis of PD.Moreover,there are differences in the hyperechoic substantia nigra area,S/M among patients with PD at different Hoehn-Yahr stages.The combination of blood uric acid detection and the hyperechoic substantia nigra area and S/M in transcranial nigrostriatal ultrasound has good predictive ability for the risk of PD occurrence,with a higher predictive efficacy than any single indicator,and has good clinical practicability.