高同型半胱氨酸血症在帕金森病中的临床意义  

The Clinical Significance of Hyperhomocysteinemia in Parkinson's Disease

作　　者：韩英[1] 刘楠[2] 黄慧玲[1] 徐春平[1] 晏泽辉[1] 

机构地区：[1]福建医科大学附属协和医院干部病房,福州350001 [2]福建医科大学附属协和医院神经内科,福州350001

出　　处：《福建医科大学学报》2011年第4期264-266,269,共4页Journal of Fujian Medical University

摘　　要：目的探讨帕金森病(PD)患者血同型半胱氨酸(Hcy)水平与运动障碍、认知状态及抑郁的关系。方法检测56例PD患者的Hcy、叶酸、VitB12水平,高于正常值者(Hcy>14μmol/L)为研究组,正常值范围内(Hcy≤14μmol/L)为对照组,应用统一PD评价量表(UPDRS)运动分量表、简易精神状态量表(MMSE)、汉密尔顿抑郁量表(HMDS)对两组患者进行比较,并分析Hcy与PD患者运动障碍、认知功能损害及抑郁的相关性。结果研究组美多巴的治疗率高于对照组(P<0.05);研究组UPDRS运动分量表评分高于对照组[(25.57±3.23)vs(21.78±5.17),P<0.05];肌强直项目评分(3.29±0.47)和运动迟缓项目评分(16.85±3.31)高于对照组相应评分[(2.43±0.51)和(12.85±1.72),P<0.01];但两组震颤项目评分差别无统计学意义(P>0.05)。PD患者Hcy水平与病程长短无显著相关(r=-0.363,P>0.05),PD患者Hcy水平与UPDRS运动分量表总评分、MMSE评分、HMDS评分具有显著性相关(分别为r=0.462,r=-0.386,r=0.469,P<0.05)。结论左旋多巴治疗可导致PD患者的Hcy增高,Hcy水平和PD患者的运动障碍、认知功能损害及抑郁倾向相关。Objective To study the relationship betwween the homocysteine（Hcy） levels and movement disorders,cognitive status,depression in patients with Parkinson＇s disease（PD）.MethodsWe determined Hcy,folate,VitB12 concentrations in 56 patients with PD,who were divided into two groups as the study group for higher range（Hcy14 μmol/L）and the control group for the normal range（Hcy≤14 μmol/L）.We compared the two groups with Unified Parkinson＇s disease Rating Scale（UPDRS）,mini-mental state examination（MMSE） and Hamilton Depression Rating Scale（HMDS）,analyzed the correction between Hcy levels and movement dysfunction,cognitive impairment,depression in patients with PD.Results The study group has significantly higher Hcy levels compared to the control group（P0.01）.The proportion of L-dopa treatment in the study group was significantly higher than that in the control group（P0.05）.The UPDRS motor subscale score of the study group was significantly higher than the control group（25.57±3.23 vs 21.78±5.17,P0.05）.The UPDRS score of rigidity items and bradykinesia items of the study group（3.29±0.47 and 16.85±3.31） were significantly higher than those of the control group（2.43±0.51 and 12.85±1.72,P0.01）.There was no significant difference in UPSRS score of tremor items between two groups（P0.05）.We found there wasn＇t significant correlation between Hcy levels and the course of PD（r=-0.363,P0.05）,but there were significant correlations between Hcy levels and UPDRS subscale score sports,MMSE score,HMDS score in patients with PD.（respectively r=0.462,r=-0.386,r=0.469,P0.05）.Conclusions L-dopa treatment in PD patients can increase Hcy levels.There are correlations between Hcy levels and movement dysfunction,cognitive impairment,depression tendencies in PD patients.

关 键 词：帕金森病 高同种半胱氨酸血症 运动障碍 认知障碍 抑郁 左旋多巴 

分 类 号：R742.5[医药卫生—神经病学与精神病学]