【摘要】 目的探讨同型半胱氨酸(homocysteine,Hcy)与帕金森病患者认知功能的相关性及其影响因素。方法选择2013年1月~2016年5月烟台市烟台山医院神经内科住院的帕金森病患者81例,根据诊断分为非智能减退组25例、轻度智能减退组32例及帕金森病痴呆组24例。另选择健康体检者19例作为对照组。登记病史及详细体检,行Hoehn-Yahr分级,通过简易智能状态检查量表评分、临床痴呆评定量表筛查认知功能障碍。测定Hcy、叶酸、维生素B12,并进行相关性分析。结果非智能减退组、轻度智能减退组和帕金森病痴呆组Hcy水平明显高于对照组,差异有统计学意义(P<0.05,P<0.01);且帕金森病痴呆组Hcy水平明显高于非智能减退组[(14.8±3.9)μmol/L vs(12.5±3.3)μmol/L,P<0.05]。所有帕金森病患者Hcy与口服左旋多巴-苄丝肼日剂量(r=0.298,P=0.000)、口服左旋多巴-苄丝肼时间(r=0.280,P=0.000)、病程(r=0.301,P=0.000)、年龄(r=0.184,P=0.019)相关,与疾病严重程度不相关。结论高Hcy很可能为帕金森病及帕金森病认知功能障碍的危险因素之一,控制多巴制剂口服剂量可能有助于帕金森病痴呆的防治。更多还原

【Abstract】 Objective To study the association between serum homocysteine(Hcy)level and cognitive impairment in PD patients.Methods Eighty-one PD patients admitted to our hospital were divided into normal cognition group(n=25),mild cognitive impairment group(n=32)and dementia group(n=24)with 19 healthy persons undergoing physical examination served as a control group.Their cognitive impairment was assessed according to their medical history,detailed physical examination data,Hoehn-Yahr scale score,MMSE score,and CDR score.Their serum levels of Hcy,folic acid and vitamin B12 were measured.The association of serum Hcy,folic acid and vitamin B12 levels with cognitive impairment was analyzed.Results The serum Hcy level was significantly higher in normal cognition group,mild cognitive impairment group and dementia group than in control group(P<0.05,P<0.01)and in dementia group than in normal cognition group(14.8±3.9μmol/L vs 12.5±3.3μmol/L,P<0.05).The serum Hcy level was associated with oral levodopa and oral benserazide daily dose,oral levodopa and oral benserazide taking time,course of PD and age(r=0.298,P=0.000;r=0.280,P=0.000;r=0.301,P=0.000;r=0.184,P=0.019)but not associated with the severity of PD.Conclusion High serum Hcy level is one of the risk factors for cognitive impairment in PD patients,and control of oral levodopa dose contributes to the prevention and treatment of dementia in PD patients.更多还原