帕金森病患者血浆乙酰胆碱水平的变化及其与姿势步态异常型的关系

Change of plasma level of acetylcholine in Parkinson disease patients and its relationship with postural instability /gait difficulty type

目的探讨帕金森病(PD)患者血浆乙酰胆碱(ACh)水平的变化及其与姿势步态异常型PD的关系。方法采用酶联免疫吸附法检测56例原发性PD患者(PD组)及21名正常对照者(正常对照组)的血浆ACh水平。比较两组间及不同类型PD患者的血浆ACh水平。采用多因素非条件Logistic回归分析姿势步态异常型PD的影响因素。结果 PD组的血浆ACh水平[(248.7±99.1)ng/L]显著低于正常对照组[(333.5±138.7)ng/L](P<0.05)。姿势步态异常型患者的血浆ACh水平[(333.8±155.0)ng/L]显著高于震颤型[(229.2±53.5)ng/L]、强直少动型[(226.1±89.2)ng/L]及混合型[(221.0±99.1)ng/L]PD患者(均P<0.05),与正常对照组差异无统计学意义。血浆ACh水平为姿势步态异常型的独立危险因素(OR=1.011,95%CI:1.000～1.021,P<0.05)。结论 PD患者血浆ACh水平下降。姿势步态异常型PD血浆ACh水平较其他亚型高,且血浆ACh水平为姿势步态异常型的独立危险因素。

Objective To investigate the change of plasma level of acetylcholine in Parkinson disease （PD） patients and its relationship with postural instability/gait difficulty type. Methods The level of acetylcholine in plasma of 56 idiopathic PD patients （PD group） and 21 normal controls （normal control group ） were measured by enzyme linked immunosorbent assay. The level of aeetylcholine in plasma among the two groups and different types were compared. Multi-factor non-conditional Logistic regression was adopted to analyze the risk factors for postural instability/gait difficulty type. Results The level of acetylcholine in plasma in PD group [ （248.7 ±99. 1 ） ng/L ] were significantly lower than normal control group [ （ 333.5 ± 138.7 ） ng/Ll （ P 〈 0. 05 ）. The level of aeetyleholine in plasma in postural instability/gait difficulty type [ （333.8±155.0 ） ng/L ] were significantly higher than tremor- dominant type [ （229.2 ±53.5 ） ng/L], akinetic-rigid type [ （226. 1 ± 89.2） ng/L] and mixed type [ （221.0 ± 99. 1 ） ng/L] （ all P 〈 0. 05 ）, and there was no significant difference between postural instability/gait difficuhy type and normal control group. Level of acetyleholine in plasma was independent risk factor for postural instability/gait difficulty type （ OR = 1.011,95 % CI： 1. 000-1. 021, P 〈 0. 05 ）. Conclusions The level of acetylcholine in plasma is decreased in PD patients. The level of aeetylcholine in plasma of postural instability/gait difficulty type in PD is significantly higher than the other types, and level of acetylcholine in plasma is independent risk factors for postural instability/gait difficulty type.