帕金森病患者唾液免疫球蛋白A、α-淀粉酶及乙酰胆碱酯酶浓度的研究  

The changes and the significance of salivary levels of immunoglobulin A, alpha-amylases and acetylcholinesterase in patients with Parkinson disease

作　　者：庞学伟[1] 陈彪[2] 

机构地区：[1]首都医科大学附属北京同仁医院干部医疗科,100730 [2]首都医科大学宣武医院神经生物室,北京100053

出　　处：《中华老年医学杂志》2016年第8期811-814,共4页Chinese Journal of Geriatrics

基　　金：国家高技术研究发展计划（863计划）（2006AA02A408）

摘　　要：目的测定帕金森病（PD）患者唾液流率、α-淀粉酶、免疫球蛋白A（IgA）、乙酰胆碱酯酶（ACHE）浓度及IgA流率。分析唾液各项生化检测指标与病程、H＆Y分级、自主神经功能障碍程度（SCOPA-AUT）评分、流涎评分、口干评分及服用左旋多巴的相关性。方法本研究为探索性的临床观察性研究，共59例受试者，PD患者38例，其中接受左旋多巴（美多巴）治疗者22例，年龄性别匹配的对照21例。收集受试者唾液约3ml。采用免疫散射比浊法检测唾液IgA，酶比色法检测α-唾液淀粉酶及AChE浓度，用BCA法测蛋白，对AChE进行标化。计算唾液流率及唾液IgA流率。结果唾液流率对照组（0．39±0．22）ml／min，PD组（0．35±0．28）ml／min IgA浓度对照组：（148．3±86．1）mg／L，PD组（183．7±126．3）mg／L；IgA流率对照组：（47．8±25．9）μg／min，PD组（46．9±27．1）μg／min；α-淀粉酶浓度对照组（1．63士1．21）×10^5U／L，PD组（1．35±9．87）×10^5U／L，AChE浓度对照组（0．12±0．08）U／mg，PD组（0．09±0．05）U／mg，两组间各指标差异无统计学意义。唾液流率与口干评分负相关（r=-0．445，P=0．005）关；IgA浓度与SCOPA-AUT评分正相关（r=0．438，P=0．006）；IgA流率与流涎评分正相关（r=0．411，P=0．01），α-淀粉酶浓度与流涎评分负相关（r=-0．327，P=0．045）。结论PD组唾液流率、α-淀粉酶及AChE浓度有减低的趋势，IgA浓度有增高的趋势。唾液α-淀粉酶浓度和IgA流率均与流涎有相关性，IgA浓度与自主神经症状的严重程度正相关，因此，这三个指标作为自主神经症状的客观评价指标有一定的临床应用前景。Objective To detect the salivary levels of IgA, alpha-amylase and aeetyleholinesterase （ACHE） and saliva flow rates of IgA in normal controls versus Parkinson disease （PD） patients, and to analyze the correlation of these salivary biochemical indexes with disease duration, H^Y rating scale, SCOPA-AUT score, sialorrhea score, dry mouth score and the use of levodopa. Methods Thirty-eight PD patients including twenty-two patients treated with levodopa, and twenty-one normal controls were selected in our study. About 3 ml saliva was collected from each subject. Salivary IgA was detected by immunoturbidimetry. Alpha-amylase and AChE were tested by enzymatic colorimetry. The protein concentration was analyzed by BCA kit to normalize ACHE. The salivary flow rate and IgA flow rate were also calculated. Results Salivary flow rate （ml/min） was （0. 39±0.22） in normal controls, and （0. 35±0.28） in PD groups; the level of IgA （rag/L） was （148.3±86.1） in normal controls, and （183.7±126.3） in PD groups; IgA flow rate （μg/min） was （47.8±25.9） in normal controls, and （46.9±27.1） in PD groups; the level of alpha-amylase （U/L） was （1.63±1.21） ×10^5 in normal control, and （1. 35±9.87）×10^5U/L in PD group; and the level of AChE（U/rag） was （0.12±0.08） in normal controls, and （0.09±0.05） in PD group. Nostatistically significant differences in above indexes were found between PD group and controls. There were negative correlations between salivary flow rate and dry mouth score （r =-0. 445, P=0. 005） and between alpha-amylase concentration and sialorrhea score （r=-0. 327, P=0. 045）. The positive associations were found between IgA concentration and the SCOPA-AUT score （r = 0. 438, P = 0. 006）, and between IgA flow rate and sialorrhea score（r= 0. 411, P = 0.01）. Conclusions Salivary flow rate and level of alpha-amylases tend to be decreased in PD patients, while IgA concentration has an upward tendency. Salivary alpha-amylases concentration an

关 键 词：帕金森病 唾液 Α淀粉酶 免疫球蛋白A 乙酰胆碱酯酶 

分 类 号：R742.5[医药卫生—神经病学与精神病学]