摘要： 目的 分析原发性帕金森病（PD）患者血浆同型半胱氨酸（Hcy）、维生素B12与叶酸水平，并与缺血性脑血管病及脑膜瘤患者进行比较。方法 检测42例PD患者、58例缺血性脑血管病和43例脑膜瘤患者的血浆Hcy、维生素B12和叶酸水平，并对各组血浆Hcy与维生素B12、叶酸水平进行相关性分析。比较病程>5年与≤5年的PD患者血浆Hcy水平，并分析其与维生素B12和叶酸水平的相关性。结果 原发性PD患者与缺血性脑血管病患者血浆Hcy水平［（15.76±8.91） μmol/L，（14.27±8.03） μmol/L］均显著高于脑膜瘤患者［（9.43±3.47） μmol/L］及正常成人［（9.25±2.98） μmol/L］。原发性PD患者血浆Hcy水平与维生素B12、叶酸水平均呈显著负相关。病程>5年的PD患者血浆Hcy水平显著高于病程≤5年的PD患者（P < 0.01），而叶酸水平则与之相反，且血浆Hcy水平与叶酸水平负相关性更强（r=-0.472，P < 0.01）。结论 原发性PD患者血浆Hcy水平显著高于脑膜瘤患者和正常人。PD患者血浆Hcy与其维生素B12、叶酸水平呈显著负相关，病程越长血清Hcy水平越高，高Hcy血症可能是PD及其临床症状发展的因素之一。

原发性帕金森病患者血浆同型半胱氨酸水平分析

李变芳¹, 韩奕勃¹, 曲婧¹, 刘济源¹, 禹红梅², 王军¹

1. 中国医科大学附属第一医院神经外科 沈阳 110001;
2. 中国医科大学附属第一医院神经内科, 沈阳 110001

收稿日期:2020-11-04出版日期:2021-08-30发布日期:2021-07-29
通讯作者:王军E-mail:cmuwj_neurosurgery@hotmail.com
作者简介:李变芳(1991-),女,医师,硕士.
基金资助:国家重点研发计划（2016YFC0105900）


关键词: 高同型半胱氨酸血症, 帕金森病, 维生素B12, 叶酸
Abstract: Objective To study the plasma levels of homocysteine (Hcy),vitamin B12,and folic acid in patients with primary Parkinson disease (PD) and compare them with the levels in the patients with ischemic cerebrovascular disease and meningioma. Methods Detection of plasma Hcy,vitamin B12 and folic acid levels was performed in 42 cases of PD,58 cases of ischemic cerebrovascular disease,and 43 cases of meningioma. Correlation analysis for plasma Hcy,vitamin B12,and folic acid levels in each group,and different PD course groups (> 5 and ≤5 years) was performed. Results The levels of plasma Hcy in patients with primary PD and those with ischemic cerebrovascular disease were 15.76±8.91 μmol/L and 14.27±8.03 μmol/L,respectively,and these levels were significantly higher than those in patients of meningioma (9.43±3.47 μmol/L) and normal population (9.25±2.98 μmol/L). In-depth analysis revealed that plasma Hcy levels in the primary PD group were strongly negatively correlated with their plasma vitamin B12 and folic acid levels. Plasma Hcy levels of PD patients with a disease course of > 5 years were significantly higher than those of the PD patients with a disease course of ≤ 5 years (P < 0.01),while the folic acid levels showed the opposite trend. The negative correlation between the plasma Hcy and folate levels was stronger (r=-0.472,P < 0.01). Conclusion Plasma Hcy levels in patients with primary PD were significantly higher than those detected in meningioma patients and normal adults. Plasma Hcy levels in PD patients had a strongly negative correlation with the vitamin B12 and folic acid levels. Since Hcy levels in patients with PD or cerebrovascular disease were comparable,hyperhomocysteinemia may be one of the factors associated with neurological symptoms and progression of PD.
Key words: hyperhomocysteinemia, Parkinson disease, vitamin B12, folic acid
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