同型半胱氨酸在帕金森病患者血浆中的变化及临床意义

A study of Plasma Homocystein in Patients with Parkinson's Disease and its Clinical Significance

目的对比研究同型半胱氨酸(homocystein,Hcy)在帕金森病(Parkinson’s disease,PD)和脑梗死患者血浆中的变化,探讨其临床意义。方法检测PD、脑梗死患者及对照组血浆Hcy水平,检测PD、脑梗死患者及对照组血浆叶酸和维生素B_(12)水平。对PD患者血浆Hcy水平与叶酸及维生素B_(12)水平进行相关性分析,对血浆Hcy水平与PD严重程度、病程、临床类型、情绪、认知功能及是否服用美多芭进行相关性分析。结果 (1)PD组、脑梗死组及对照组血浆Hcy水平分别为20±11μmol/L、16±7μmol/L及11±2μmol/L,PD组和脑梗死组血浆Hcy水平均高于对照组,差异有统计学意义(P<0.05或0.01),PD组血浆Hcy水平明显高于脑梗死组(P<0.01);(2)PD组血浆叶酸和维生素B_(12)水平分别为6±5μg/L和514±345ng/L。PD组血浆叶酸和Hcy水平呈明显负相关(r=-0.453,P<0.01);血浆维生素B_(12)和Hcy水平无明显相关性(r=-0.268,P>0.05)。(3)按照Hoehn-Yahr分期对PD严重程度进行分组,轻、中、重度PD组血浆Hcy水平分别为16±8μmol/L、21±9μmol/L和35±3μmol/L,三组之间差异有统计学意义(P<0.05);(4)血浆Hcy水平与病程、临床类型、情绪、认知功能及是否服用美多芭无关。结论 PD组和脑梗死组血浆Hcy水平明显增高,PD组Hcy水平与疾病严重程度密切相关,PD组血浆叶酸和Hcy水平呈明显负相关。

Objective To conduct a comparsion study on the change of plasma homocystein （Hcy） in patients with Parkinson＇s disease （PD） and cerebral infarction, and to explore its clinical significance. Methods We examined the levels of plasma Hcy, folic acid and vitamin B12 of patients among PD, cerebral infarction and control group. The levels of plasma Hcy, folic acid and vitamin B12 of PD patients were analyzed. The relationships among Hey level and PD severity, PD duration, clinical types, mood status, cognitive function and Madopar treatment were analyzed. Results 1 Hey levels in patients with PD, cerebral infarction and control group were 20±11 μmol/L, 1617 μmol/L and 11±3μmol/L, respectively. Hey levels in patients with PD and cerebral infarction were all significantly higher than that of control group （P〈0.05 or P〈0.01, respectively）. Hcy level in PD patients was significantly higher than that of patients with cerebral infarction （P〈0.01）; 2 The levels of plasma folic acid and vitamin B12 in PD patients were 6±5μg/L and 514± 345ng/L; it was negatively correlated （r=-0.453, P〈0.01） between the level of Hcy and folic acid in PD patients; and there was no significant correlation between Hcy level and the level of vitamin BI2 （r=-0.268, P〉0.05）; 3 Hey levels in PD patients with mild, moderate and severe degrees evaluated by Hoehn-Yahr staging were significantly different （16±8 μmol/L, 21±9 μmol/L and 35±3 μmol/L, respectively, P〈0.05）; 4 There were no relationships among Hey level and PD duration, clinical types, mood status, cognitive function and Madopar treatment. Conclusion Hcy level in PD patients was significantly elevated, which was closely correlated with disease severity. Hey level and folic acid level was negatively correlated.