帕金森病患者伴发高同型半胱氨酸血症的相关因素分析

目的探讨帕金森病(Parkinson’s disease,PD)患者伴发高同型半胱氨酸血症(hyperhomocysteinemia,Hhcy)与左旋多巴(levodopa,L-dopa)治疗的关系。方法收集门诊154例PD患者,检测其同型半胱氨酸(Homocysteine,Hcy)的水平。高于正常值者列为研究组,正常值范围内为对照组,2组就年龄、性别、病程、L-dopa治疗情况、叶酸和维生素B12水平等进行对照分析。结果研究组使用L-dopa治疗者比例(62/76))明显高于对照组(44/78)(P0.01),而其他因素包括性别、年龄、病程、叶酸和维生素B12浓度对Hcy的升高而无明显影响(P0.05);治疗组血浆Hcy浓度(24.34±8.67)umol/L明显高于未治疗组(14.26±6.11)umol/L(P0.01)。结论L-dopa治疗可以导致PD患者的血浆Hcy水平升高,可能是PD患者伴发Hhcy的独立危险因素。

Analysis on influence factors of hyperhomocysteinemia in patients with Parkinson's disease

Objective To study the relationship between hyperhomocysteinemia（Hhcy） and L-dopa treatment in the patients with Parkinson＇s disease（PD）.Methods The total of 158 patients with PD in our clinic were collected.The patients were divided into two groups based on their plasma homocysteine（Hcy）levels,study group（Hcy in higher level,〉14 umol/L） and control group（Hcy in normal level,≤14 umol/L）.The factors,including age,gender,PD duration,L-dopa treatment,folic acid and vitamin B12 levels were compared between these two groups.Results The factors,such as age,gender,PD duration,levels of vitamin B12 and folate,have no effection on plasma Hcy level.However,L-dopa treatment has the effection on Hcy level.The proportion of patients with L-dopa treatment in the study group was significantly higher than that in the control group（P〈0.01）.Compared with those without treatment（14.26±6.11）umol/L, the plasma Hcy level was significantly higher in patients treated with L-dopa （24.34±8.67）umol/L（P〈0.01）.Conclusions L-dopa treatment increases plasma Hcy level and may be an independent risk factor of Hhcy in PD patients.