高同型半胱氨酸血症与帕金森病认知功能障碍的关系∗

摘要

[Abstrac] Objective To detect the relationship between homocysteine(HCY)levels in serum and clinical stages and cognitive impairment(CI)of patients with Parkinson′s disease (PD).Methods The HCY of fasting venous blood of both PD group(n=55)and control group(n=55)were evaluated and Hoehn-Yahr(H-Y)stage and Montreal cognitive assessment(MoCA)scale were conducted in PD group.The results were statistically analyzed. Results The HCY levels in PD group [(13.23±4.61)μmol/L]were significantly higher than control group(P <0.01),which can be recognized as hyperhomocysteinemia.No significant difference was found among different H-Y stages of PD group (rs =0.064,P >0.05).Statistically Significant differences of HCY levels were found among CI group,CI-free group and healthy control group (P <0.05).Difference in MoCA scores between CI group and CI-free group was statistically significant(P <0.05).Conclusion High HCY level of serum is one of the independent risk factors for PD,but can not be used to evaluate severity of PD;MoCA scale can properly assess CI for PD.%目的：探讨帕金森病(Parkinson′s disease,PD)患者血清同型半胱氨酸(homocysteine,HCY)水平与临床分期、认知功能障碍的关系。方法收集 PD 组及健康对照组患者各55例,两组均测定空腹静脉血 HCY 值；PD 组按 Hoehn-Yahr(H-Y)分期标准进行分期,蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)测定认知功能,并对结果进行统计学分析。结果PD 组患者血清 HCY 水平为(13.23±4.61)μmol/L,明显高于对照组(P <0.05),属高 HCY 血症；PD 组患者不同 H-Y 分期之间的血清 HCY 水平比较无等级相关性(rs =0.064, P >0.05)；PD 组患者中认知障碍组与无认知障碍组及健康对照组间的血清 HCY 水平比较差异有统计学意义(P <0.05)；PD 组患者中认知功能障碍组和无认知功能障碍组 MoCA 分值比较差异有统计学意义(P <0.05)。结论血清高 HCY 是 PD 独立危险因素之一,但不能用来评定疾病严重程度,MoCA 可较好地判定 PD 认知功能障碍。