帕金森病患者脑脊液同型半胱氨酸水平与认知功能障碍相关性研究

Relationship between level of cerebrospinal fluid homocysteine and cognitive dysfunction in patients with Parkinson’s disease

摘要:

目的：讨论脑脊液同型半胱氨酸（Homocysteine，HCY）含量与帕金森病（Parkinson’s disease，PD）患者认知功能障碍相关性。方法：对PD患者进行一般情况、疾病情况、认知功能调查，行腰椎穿刺术留取脑脊液，采用高效液相色谱联合免疫荧光检测法测定HCY含量，分析认知功能和脑脊液HCY含量之间相关性。结果：在平衡了PD患者年龄、抑郁程度、病程、帕金森联合评分量表评分及左旋多巴用量对脑脊液HCY含量的影响后，PD认知障碍组简易智能状态检查量表（Mini mental state examina－tion，MMSE）、蒙特利尔认知评估量表（Montreal cognitive assessment，MoCA）、Rey文字记忆测试（Rey auditory verbal learning test，RAVLT）、符号数字转换测试（Symbol digit modalities test，SDMT）、韦氏智力测试———积木测验（Wechsler intelligence scale-block design，BD）均与脑脊液HCY存在显著相关性。结论：脑脊液HCY增高与PD认知功能障碍存在显著相关性，这提示脑脊液HCY增高是PD认知损害的重要危险因素之一。

Abstract:

Objective：To study the relationship between the level of cerebrospinal fluid homocysteine（HCY） and the cognitive dys－function among patients with Parkinson’s disease（PD）. Methods：The basic information，disease situation and cognitive function of pa－tients with PD were investigated and lumbar puncture was performed to extract cerebrospinal fluid. The levels of cerebrospinal fluid HCY were determined by high performance liquid chromatography combined with fluorescence detection method. The correlation be－tween cerebrospinal fluid HCY levels and the cognitive function was assessed. Results：The scores of the mini mental state examina－tion（MMSE），montreal cognitive assessment（MoCA），rey auditory verbal learning test（RAVLT），symbol digit modalities test（SDMT） and the wechsler intelligence scale-block design（BD） all showed significant correlations with cerebrospinal fluid HCY in patients with PD after eliminating the bias of age，depression，course of disease，scores of unified Parkinson’s disease rating scale and Levodopa dosage. Conclusions：The elevated cerebrospinal fluid HCY level is significantly correlated with the cognitive dysfunction. The in－crease of cerebrospinal fluid HCY maybe one of the main important risk factors of PD patients’ cognitive dysfunction.