帕金森病患者左旋多巴治疗时测定血同型半胱氨酸水平的临床意义  

Association of levodopa administration with hyperhomocysteinemia in patients with Parkinson's disease

作　　者：张长国[1] 张强春[1] 陈静[1] 冯耀耀[1] 

机构地区：[1]湖州市第三人民医院神经内科,313000

出　　处：《浙江医学》2013年第15期1435-1437,共3页Zhejiang Medical Journal

基　　金：湖州市科技局计划项目(2009YS09)

摘　　要：目的探讨接受左旋多巴治疗的帕金森病(PD)患者血同型半胱氨酸水平与临床特征的关系及测定的意义。方法测定44例PD患者(PD组)与38例健康体检者(对照组)的血同型半胱氨酸、叶酸、维生素B_(12)水平并进行比较,将PD组分为≥14mmol/L与<14mmol/L两个亚组,比较两组统一帕金森量表评分。分析PD患者血同型半胱氨酸水平的影响因素。结果 PD组患者血同型半胱氨酸水平[(16.1±7.8)μmol/L]高于对照组[(10.9±2.8)μmol/L],高同型半胱氨酸水平与叶酸、维生素B_(12)水平呈负相关(r=-0.467,P<0.01;r=-0.347,P<0.05),与左旋多巴用量及UPDRSⅢ呈正相关(r=0.464,P<0.01;r=0.378,P<0.05),与年龄、起病年龄、病程、左旋多巴使用时间无关(均P>0.05),≥14mmol/L与<14mmol/L两组UPDRS评分的差异无统计学意义(P>0.05)。结论左旋多巴治疗会导致高同型半胱氨酸血症发生,补充叶酸及维生素B_(12)治疗可能是有效的治疗方法 。Objective To investigate the association of levodopa administration with hyperhomocysteinemia in patients with Parkinson＇s disease （PD）. Methods Forty four PD patients and 38 healthy subjects were included in the study. The serum homocysteine, folic acid and vitamin B12 levels were measured. Pearson correlation was applied to analyze related factors influ-encing blood homocysteine levels. The scores of unified Parkinson＇s disease rating scale III （UPDRSIII） were compared between patients with homocysteine level〉14 mmol/l and those〈14 mmol/l. Results Homocysteine levels were significantly higher in PD patients than those in controls. Hyperhomocysteinemia was negatively correlated with vitamin B12 and folate levels and positively correlated with UPDRS scores and levodopa dose. There was no correlation of homocysteine level with age, onset age and dura-tion of disease, duration of levodopa administration. There were no significant difference in UPDRS scores between 〉14mmol/l and〈14mmol/l subgroups. Conclusion Administration of levodopa is associated with UPDRS and high blood homocysteine lev-els,which indicates that levodopa may induce hyperhomocysteinemia in patients with Parkinson＇s disease.

关 键 词：帕金森病 同型半胱氨酸 叶酸 维生素B12 统一帕金森症状评分 

分 类 号：R742.5[医药卫生—神经病学与精神病学]