目的：分析血管性帕金森综合征（vascular Parkinson's syndrome，VPS）患者氧化应激反应与认知功 能的相关性。方法：纳入64例VPS患者为VPS组，另选取同期医院接诊的64例帕金森病（Parkinson's disease，PD）患者为PD组，以及同期64例健康体检者为健康对照组，以蒙特利尔认知评估量表（MoCA）评分 评估受检者认知功能，检测、比较三组氧化应激指标[超氧化物歧化酶（superoxide dismutase，SOD）、丙二 醛（malonaldehyde，MDA）]、MoCA评分，根据Hoehn-Yahr（H-Y）分级将VPS组患者分为早期亚组（29例） 和中晚期亚组（35例），根据MoCA评分将VPS组患者分为认知障碍亚组（44例）和无认知障碍亚组（20 例），Pearson分析血清SOD、MDA与MoCA评分的相关性，绘制受试者工作曲线（ROC），分析SOD、MDA 对认知功能障碍的预测价值，单因素、多因素 Logistic 回归分析 VPS 患者发生认知功能障碍的危险因 素。结果：VPS组的血清MDA水平高于PD组、健康对照组（P＜0.05），血清SOD、MoCA评分均低于PD 组、健康对照组（P＜0.05）。中晚期亚组血清MDA水平高于早期亚组（P＜0.05），中晚期亚组血清SOD水 平、MoCA评分均低于早期亚组（P＜0.05）。认知障碍亚组的血清MDA水平高于无认知障碍亚组（P＜ 0.05），血清SOD水平低于无认知障碍亚组（P＜0.05）。Pearson分析显示，血清SOD水平与MoCA评分呈 显著正相关（r=0.398，P＜0.001），血清 MDA 水平与 MoCA 评分呈显著负相关（r=－0.432，P＜0.001）。 SOD、MDA联合检测预测认知功能障碍的曲线下面积为0.811（95%CI 0.727～0.954），灵敏度（93.28%）、 特异度（90.17%）均高于SOD（76.67%、74.09%）、MDA（74.28%、71.46%）单独检测（P＜0.05）。年龄、高尿 酸血症、血清Hcy、脑梗死部位、脑梗死面积、微出血、SOD、MDA是VPS患者发生认知功能障碍的危险因 素（P＜0.05）。结论：VPS患者血清MDA呈异常高表达，血清SOD呈异常低表达，与患者认知功能存在一 定联系，联合检测MDA、SOD可提高对VPS患者认知功能障碍的预测效能。

To analyze the correlation between oxidative stress response and cognitive function in patients with vascular Parkinson's syndrome (VPS). Methods: A total of 64 patients with VPS were enrolled in the VPS group, 64 patients with Parkinson's disease (PD) admitted to the hospital during the same period were selected as the PD group, and 64 healthy individuals undergoing physical examinations during the same period were included as the healthy control group. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. Oxidative stress indicators [superoxide dismutase (SOD) and malonaldehyde (MDA)] and MoCA scores were measured and compared among the three groups. The VPS group was further divided into an early subgroup (29 patients) and a middle-to-late subgroup (35 patients) based on Hoehn-Yahr (H-Y) staging, and into a cognitive impairment subgroup (44 patients) and a non-cognitive impairment subgroup (20 patients) based on MoCA scores. Pearson correlation analysis was conducted to assess the relationship between serum SOD, MDA, and MoCA scores. Receiver Operating Characteristic (ROC) curves were plotted to analyze the predictive value of SOD and MDA for cognitive impairment. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for cognitive impairment in VPS patients. Results: The VPS group had higher serum MDA levels than the PD and healthy control groups (P<0.05), and lower serum SOD levels and MoCA scores than the PD and healthy control groups (P<0.05). The middle-to-late subgroup had higher serum MDA levels than the early subgroup (P<0.05) and lower serum SOD levels and MoCA scores than the early subgroup (P<0.05). The cognitive impairment subgroup had higher serum MDA levels than the non-cognitive impairment subgroup (P<0.05) and lower serum SOD levels than the non-cognitive impairment subgroup (P<0.05). Pearson correlation analysis showed a significant positive correlation between serum SOD levels and MoCA scores (r=0.398, P<0.001) and a significant negative correlation between serum MDA levels and MoCA scores (r=－0.432, P<0.001). The area under the ROC curve for combined detection of SOD and MDA in predicting cognitive impairment was 0.811 (95% CI: 0.727～0.954), with sensitivity (93.28%) and specificity (90.17%) higher than those of SOD (76.67%, 74.09%) and MDA (74.28%, 71.46%) alone (P<0.05). Age, hyperuricemia, serum homocysteine (Hcy) levels, cerebral infarction location, cerebral infarction size, microbleeds, SOD, and MDA were identified as risk factors for cognitive impairment in VPS patients (P<0.05). Conclusion: VPS patients exhibit abnormally high serum MDA levels and abnormally low serum SOD levels, which are associated with their cognitive function. Combined detection of MDA and SOD can improve the predictive accuracy for cognitive impairment in VPS patients.