高血压与临床很可能帕金森病关系的初步探讨

Relationship between hypertension and clinically probable Parkinson's disease

目的 探讨林县营养缺乏人群高血压与临床很可能帕金森病 (ClinicallyProbableParkinson’sdisease,PPD)之间的关系 ,为早期防治帕金森病 (PD)提供理论依据。方法 采用前瞻性队列研究方法。人群血压资料来源于1985年林县营养干预试验开始时研究对象的基线调查。病例的诊断 ,通过两个步骤完成 ,即第一步采用调查问卷与体格检查相结合的办法 ,对队列人群进行PPD的筛查 ,第二步对可疑病例 ,由中美神经科专家联合诊断 ,并依据英国帕金森病协会脑库临床诊断标准进行PPD的临床诊断。资料处理采用线性趋势检验 ,及非条件Logistic回归。 结果 单因素分析显示 :高血压与PPD有统计学关联 ,其RR值为 1 6 4 8( 1 14 7～ 2 36 8) ;用年龄、性别、吸烟、饮酒等可能的混杂因素进行调整后 ,上述关联依然存在。分性别后统计显示 ,男性高血压与PPD无统计学关联。女性高血压与PPD统计学上有显著性相关 ,其RR值调整前为 2 347( 1 347～ 4 0 91) ,经混杂因素进行调整后关联依然存在。随着血压的增高 ,其对应的RR值也随之增加 ,经线性趋势检验 ( χ2 =11 32 5 ,P =0 0 0 3) ,表明血压与PPD存在剂量 -反应关系。结论 在林县营养缺乏地区 ,高血压是 5 5岁以后女性居民罹患PPD的危险因素之一 。

Objective To investigate the relationship between hypertension and clinically probable Parkinson's disease (PPD) in the nutrition-deficient population in Linxian county and provide a basis early prevention and treatment for PD.Methods A prospective cohort study was conducted.The blood pressure data of population were collected from the data of baseline survey to subjects in Linxian Nutrition Intervention in 1985.The diagnosis of PPD was made by two steps.First,the cohort was screened by combining questionnaire and physical examination together.Second,those suspicious cases were poly-diagnosed by neutral medical experts coming from China and America,as well as according to UK Parkinson's Society Brain Bank Clinical Diagnostic Criteria.And statistic analyses included linear trend test and logistic regression.Results The result of logistic regression showed hypertension was associated with the incidence of clinically probable PD in the population aged over 55 years. RR =1.648(1.147-2.368).When the relation was adjusted by some possible confounding factors,such as age,gender,smoking, drinking,it still existed.Then data were analyzed by different gender.For males,hypertension was not significantly associated with the incidence of clinically probable PD.But for females,hypertension was remarkably associated with the incidence of PPD. RR =2.347(1.347-4.091).And the relation was adjusted by the possible confounding factors,it still existed. RR values increased with the blood pressure increase (Trend test,χ\+2=11.325, P =0.003) which indicated that there was a dose-response relationship between blood pressure and PPD.Conclusion Hypertension was one of the risk factors for PPD in the female residents older than 55 in Linxian county,and the incidence risk for PPD increased as BP increased.