血浆同型半胱氨酸水平与帕金森病相关研究

Correlational studies of serum homocysteine level and Parkinson′s disease

目的探讨血浆同型半胱氨酸(homocysteine,Hcy)水平与帕金森病(Parkinson's disease,PD)之间的相关性,观察B族维生素、恩他卡朋治疗左旋多巴诱导的高同型半胱氨酸血症的疗效。方法选择年龄及性别基本匹配的PD病例90例(未治疗的病例15例、非左旋多巴治疗的病例21例、左旋多巴治疗的病例54例)。体检健康老年人90例。检测PD患者、健康老年人的血浆同型半胱氨酸、维生素B12和叶酸水平。将左旋多巴治疗的PD病例采用随机数字表法随机分为3组,分别给予口服安慰剂、B族维生素(维生素B12 1 mg/d、叶酸500 ug/d)和恩他卡朋200 mg/d,检测三组用药前后的血浆Hcy水平。结果各组血浆Hcy水平差异有统计学意义(F=25.580,P=0.001)。PD患者血浆Hcy水平高于健康老年人组(P<0.05)。左旋多巴治疗PD组血浆Hcy水平高于未治疗PD组和非左旋多巴胺治疗PD组(P<0.05)。PD组叶酸水平低于健康老年人组(P<0.05)。维生素B12、叶酸和恩他卡朋均能使左旋多巴治疗的PD患者血浆Hcy水平下降(P<0.05)。相关分析显示,PD患者血浆Hcy水平与叶酸水平呈负相关(r=-0.425,P=0.000)。结论高同型半胱氨酸血症可能是帕金森病的危险因素之一,并与缺乏B族维生素和使用左旋多巴治疗有一定的联系。B族维生素、恩他卡朋可能降低左旋多巴引起的高同型半胱氨酸血症。

Objective To investigate the correlation between serum homocysteine level and Parkinson′s disease（PD）.And observed efficacy of vitamins B and entacapone in the treatment of levodopa-induced hyperhomocysteinemia.Methods 90 patients with PD and 90 cases of normal elderly group matching with ages and sexual were recruited in this study.Serum homocysteine,vitamin B12 and folate levels of all cases were detected.90 PD patients were randomly divided into 3 groups using random number table method,then respectively treated with placebo,vitamins B（VB12 1 mg/d、folate 500μg/d） and entacapone 200 mg daily.Serum Hcy level of three groups were checked before and after treatment.Results The serum Hcy level of all groups were significantly different（F=25.580,P=0.001）.The Hcy levels of PD group were significantly higher than the normal elderly group（P〈0.05）.Plasma Hcy levels of PD patients treatment with levodopa group was significantly higher than the untreated and non-L-dopa treatment PD group（P〈0.05）.Folate levels of PD group was lower than that of the normal elderly group（P〈0.05）.VB12,folate and entacapone could reduce serum Hcy levels of PD patients（P〈0.05）.Serum Hcy levels were negatively correlated with folate levels（r=-0.425,P〈0.05）.Conclusions Hyperhomocysteinemia may be a risk factor for Parkinson′s disease,and connect with the lack of vitamins B and treatment with levodopa.Vitamins B and entacapone may reduce levodopa-indued hyperhomocysteinemia.