帕金森病合并异动症患者血浆维生素B_(12)水平的相关因素研究
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摘要
目的观察维生素B_(12)(vitamin B_(12),VitB_(12))、叶酸(folic acid,FA)、同型半胱氨酸(homocysteine,Hcy)在帕金森异动症患者血浆中的变化,分析VitB_(12)水平变化的相关因素。方法237例帕金森病患者根据异动症定义分为异动症组(63例)和非异动症组(174例),比较2组血浆VitB_(12)、FA、Hcy水平,将差异有统计学意义的指标选出,异动症组按性别、年龄、起病年龄、病程、左旋多巴使用时间、日多巴总量、H-Y分期分组,并进行组间对比。结果异动症组血浆Hcy、FA水平与非异动症组比较差异无统计学意义(P>0.05)。异动症组血浆VitB_(12)水平与非异动症组比较差异有统计学意义(P<0.01)。异动症组中不同性别、年龄、起病年龄、病程、使用多巴时间及H-Y分期患者血浆维生素B_(12)水平无明显差异(P>0.05),而不同日多巴总量患者血浆VitB_(12)水平差异有统计学意义(P<0.05),且日多巴总量越大,血浆VitB_(12)水平越低。结论帕金森病异动症患者血浆VitB_(12)水平明显降低,影响异动症患者血浆VitB_(12)变化的因素为日多巴总量。
Objective To observe the changes of plasma levels of vitamin B_(12) ,folic acid,homocysteine and the relevant factor of causing change in patients with Parkinson’s disease and dyskinesias.Methods 237patients of Parkinson’s disease were divided into dyskinesias(63patients)and non-dyskinesias(174patients)according to the clinical definition of dyskinesias.Plasma levels of vitamin B_(12) ,folic acid,homocysteine in two groups were compared.Then,we elected discrepant indicator and contrasted its difference in the different gender,age,age onset,duration,the cumulative time of medication of levodopa,daily volume dose of levodopa and Hoehn-Yahr staging in dyskinesias.Results The difference of the plasma levels of Hcy and FA of dyskinesias and nondyskinesias wasn’t statistical significance(P>0.05).The difference of the plasma level of vitamin B_(12) of dyskinesias and non-dyskinesias was statistical significance(P<0.01).The plasma level of vitamin B_(12) of dyskinesias weren’t statistically significant difference in terms of gender,age,age onset,duration,the cumulative time of medication of levodopa,and Hoehn-Yahr staging(P>0.05).The plasma level of vitamin B_(12) of dyskinesias related to the daily volume dose of levodopa was statistical significance(P<0.05).The bigger daily volume dose of levodopa,the lower plasma level of vitamin B_(12) .Conclusion The plasma level of vitamin B_(12) of dyskinesias is lower.The factor affecting the plasma level of vitamin B_(12) of dyskinesiasis the daily volume dose of levodopa.
Objective To observe the changes of plasma levels of vitamin B_(12) ,folic acid,homocysteine and the relevant factor of causing change in patients with Parkinson’s disease and dyskinesias.Methods 237patients of Parkinson’s disease were divided into dyskinesias(63patients)and non-dyskinesias(174patients)according to the clinical definition of dyskinesias.Plasma levels of vitamin B_(12) ,folic acid,homocysteine in two groups were compared.Then,we elected discrepant indicator and contrasted its difference in the different gender,age,age onset,duration,the cumulative time of medication of levodopa,daily volume dose of levodopa and Hoehn-Yahr staging in dyskinesias.Results The difference of the plasma levels of Hcy and FA of dyskinesias and nondyskinesias wasn’t statistical significance(P>0.05).The difference of the plasma level of vitamin B_(12) of dyskinesias and non-dyskinesias was statistical significance(P<0.01).The plasma level of vitamin B_(12) of dyskinesias weren’t statistically significant difference in terms of gender,age,age onset,duration,the cumulative time of medication of levodopa,and Hoehn-Yahr staging(P>0.05).The plasma level of vitamin B_(12) of dyskinesias related to the daily volume dose of levodopa was statistical significance(P<0.05).The bigger daily volume dose of levodopa,the lower plasma level of vitamin B_(12) .Conclusion The plasma level of vitamin B_(12) of dyskinesias is lower.The factor affecting the plasma level of vitamin B_(12) of dyskinesiasis the daily volume dose of levodopa.
引文
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[15]MEMEDI M,WESTIN J,NYHOLM D.Spiral drawing during self-rated dyskinesia is more impaired than during self-rated Off[J].Parkinsonism Relat Disord,2013,19(5):553-556.
[16]FRANCARDO V,CENCI M A.Investigating the molecular mechanisms of L-DOPA-induced dyskinesia in the mouse[J].Parkinsonism Relat Disord,2014,20(Suppl 1):S20-S22.
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[20]JENNER P.Wearing off,dyskinesia,and the use of continuous drug delivery in Parkinson's disease[J].Neurol Clin,2013,31(3Suppl):S17-S35.
[21]GORGONE G,CURRO M,FERLAZZO N,et al.Coenzyme Q10,hyperhomocysteinemia and MTIIFR C677T polymorphism in levodopa-treated Parkinson’s disease patients[J].Neuromolecular Med,2012,14(1):84-90.
[22]MICHALOWSKA M,FISZER U,SZATANOWSKI T.Motor levodopa-induced complication in Parkinson’s disease[J].Pol Merkur Lekarski,2016,40(240):357-361.
[23]POLITIS M,OERTEL W H,WU K,et al.Graftinduced dyskinesias in Parkinson's disease:High striatal serotonin/dopamine transporter ratio[J].Mov Disord,2011,26(11):1 997-2 003.
[24]KADOWAKI T,KOMAGAMINE T,SUZUKI K,et al.Oseltamivir-induced dyskinesia in Parkinson's disease[J].Parkinsonism Relat Disord,2011,17(2):133-134.
[25]BARKER R A,KUAN W L.Graft-induced dyskinesias in Parkinson's disease:what is it all about?[J].Cell Stem Cell,2010,7(2):148-149.
[26]STATHIS P,KONITSIOTIS S,ANTONINI A.Dopamine agonists early monotherapy for the delay of development of levodopa-induced dyskinesias[J].Expert Rev Neurother,2015,15(2):207-213.
[27]CERVANTES-ARRIAGA A,RODRGUEZ-VIOLANTE M,GONZLEZ-LATAPP,et al.ApoE polymorphisms and dopaminergic replacement therapy in Parkinson's disease[J].Rev Med Inst Mex Seguro Soc,2014,52(1):14-18.
[28]LIASHCHENKO E A,SKRIPKINA N A,LEVIN O S.Influence of levodopa,stalevo on dyskinesia in Parkinson's disease:STRIDE-PD study[J].Zh Nevrol Psikhiatr Im S S Korsakova,2013,113(7Pt 2):62-68.
[29]KHAN T S.Off spells and dyskinesias:pharmacologic management of motor complications[J].Cleve Clin J Med,2012,79(Suppl 2):S8-S13.
[30]SAMA,PREZ-LOPEZ C,ROMAGOSA J,et al.Dyskinesia and motor state detection in Parkinson's disease patients with a single movement sensor[J].Conf Proc IEEE Eng Med Biol Soc,2012,2012:1 194-1 197.
[31]RAJABALLY Y A,MARTEY J.Levodopa,Vitamins,ageing and the neuropathy of Parkinson’s disease[J].J Neurol,2013,260(11):2 844-2 848.
[32]MCCADDON A.Vitamin B12in neurology and ageing:Clinical and genetic aspects[J].Biochimie,2013,95(5):1 066-1 076.
[33]SHEN L.Association beweeten B Vitamins and Parkinson’s disease[J].Nutrients,2015,7(9):7 190-9 208.
[34]HEUMANN R,MORATALLA R,HERRERO M T,et al.Dyskinesia in Parkinson's disease:mechanisms and current non-pharmacological interventions[J].J Neurochem,2014,130(4):472-489.
[2]CHONDROGIORGI M,TATSIONI A,REICHMANN H,et al.Dopamine agonist monotherapy in Parkinson’s disease and potential risk factors for dyskinesia:a metaanalysis of levodopa-controlled trials[J].Eur J Neurol,2014,21(3):433-440.
[3]FIORENTINI C,SAVOIA P,SAVOLDI D,et al.Receptor heteromers in Parkinson's disease and LDOPA-induced dyskinesia[J].CNS Neurol Disord Drug Targets,2013,12(8):1 101-1 113.
[4]HUOT P,JOHNSTON T H,KOPRICH J B,et al.The pharmacology of L-DOPA-induced dyskinesia in Parkinson's disease[J].Pharmacol Rev,2013,65(1):171-222.
[5]KOCER B,GUVEB H,CONKBAYIR I,et al.The Effect of Hyperhomocysteinemia on Motor Symptoms,Cognitive Status,and Vascular Risk in Patients with Parkinson’s Disease[J].Parkinson’s Dis,2016,8(6):1 103-1 115.
[6]CAMICIOLI R M,BOUCHARD T P,SOMERVILLE M J.Homocysteine is not associated with global motor or cognitive measuers in nondemented older Parkinson’s disease patients[J].Mov Disord,2009,24(2):176-182.
[7]MILLER J W,SELHUB J,NADEAU M R,et al.Effect of L-dopa on plasma homocysteinein PD patients relationship to B-vitamin status[J].Neurology,2003,60(7):1 125-1 129.
[8]BENKLER M,AGMON-LEVIN N,HASSIN-BAER S,et al.Immunology,autoimmunity,and autoantibodies in Parkinson's diseasee[J].Clin Rev Allergy Immunol,2012,42(2):164-171.
[9]GURIDI J,GONZALEZ-REDONDO R,OBESO J A.Clinical features,pathophysiology,and treatment of levopa-induced dyskinesias in Parkinson’s disease[J].Parkinsons Dis,2012:9431599.
[10]DHALL R,KREITZMAN D L.Advanced in levodopa therapy for Parkinson disease:Review of RYTARY(carbidopa and levodopa)clinical efficacy and safety[J].Neurology,2016,86(14):S13-S24.
[11]RIECK M,SCHUMACHER-SCHUH A F,ALTMANN V,et al.DRD2haplotype is associated with dyskinesia induced by levodopa therapy in Parkinson's disease patients[J].Pharmacogenomics,2012,13(15):1 701-1 710.
[12]KO W K,LI Q,BEZARD E.Effects of L-tryptophan on L-DOPA-induced dyskinesia in the L-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-treated macaque model of Parkinson's disease[J].Neurosci Lett,2014,566:72-76.
[13]ALEGRE M,LPEZ-AZCRATE J,ALONSOFRECH F,et al.Subthalamic activity during diphasic dyskinesias in Parkinson's disease[J].Mov Disord,2012,27(9):1 178-1 181.
[14]DOTCHIN C L,GRAY W K,DEWHURST F,et al.Parkinson's disease related dyskinesia in a Tanzanian population[J].Parkinsonism Relat Disord,2015,21(9):1 109-1 110.
[15]MEMEDI M,WESTIN J,NYHOLM D.Spiral drawing during self-rated dyskinesia is more impaired than during self-rated Off[J].Parkinsonism Relat Disord,2013,19(5):553-556.
[16]FRANCARDO V,CENCI M A.Investigating the molecular mechanisms of L-DOPA-induced dyskinesia in the mouse[J].Parkinsonism Relat Disord,2014,20(Suppl 1):S20-S22.
[17]IRAVANI M M,MCCREARY A C,JENNER P.Striatal plasticity in Parkinson's disease and L-dopa induced dyskinesia[J].Parkinsonism Relat Disord,2012,18(Suppl 1):S123-S125.
[18]GRIFFITHS R I,KOTSCHET K,ARFON S,et al.Automated assessment of bradykinesia and dyskinesia in Parkinson's disease[J].J Parkinsons Dis,2012,2(1):47-55.
[19]MADENCI G,BILEN S,ARLI B,et al.serum iron,Vitamin B12 and folic acid levels in parkinson’s disease[J].Neurochem Res,2012,37(7):1 436-1 441.
[20]JENNER P.Wearing off,dyskinesia,and the use of continuous drug delivery in Parkinson's disease[J].Neurol Clin,2013,31(3Suppl):S17-S35.
[21]GORGONE G,CURRO M,FERLAZZO N,et al.Coenzyme Q10,hyperhomocysteinemia and MTIIFR C677T polymorphism in levodopa-treated Parkinson’s disease patients[J].Neuromolecular Med,2012,14(1):84-90.
[22]MICHALOWSKA M,FISZER U,SZATANOWSKI T.Motor levodopa-induced complication in Parkinson’s disease[J].Pol Merkur Lekarski,2016,40(240):357-361.
[23]POLITIS M,OERTEL W H,WU K,et al.Graftinduced dyskinesias in Parkinson's disease:High striatal serotonin/dopamine transporter ratio[J].Mov Disord,2011,26(11):1 997-2 003.
[24]KADOWAKI T,KOMAGAMINE T,SUZUKI K,et al.Oseltamivir-induced dyskinesia in Parkinson's disease[J].Parkinsonism Relat Disord,2011,17(2):133-134.
[25]BARKER R A,KUAN W L.Graft-induced dyskinesias in Parkinson's disease:what is it all about?[J].Cell Stem Cell,2010,7(2):148-149.
[26]STATHIS P,KONITSIOTIS S,ANTONINI A.Dopamine agonists early monotherapy for the delay of development of levodopa-induced dyskinesias[J].Expert Rev Neurother,2015,15(2):207-213.
[27]CERVANTES-ARRIAGA A,RODRGUEZ-VIOLANTE M,GONZLEZ-LATAPP,et al.ApoE polymorphisms and dopaminergic replacement therapy in Parkinson's disease[J].Rev Med Inst Mex Seguro Soc,2014,52(1):14-18.
[28]LIASHCHENKO E A,SKRIPKINA N A,LEVIN O S.Influence of levodopa,stalevo on dyskinesia in Parkinson's disease:STRIDE-PD study[J].Zh Nevrol Psikhiatr Im S S Korsakova,2013,113(7Pt 2):62-68.
[29]KHAN T S.Off spells and dyskinesias:pharmacologic management of motor complications[J].Cleve Clin J Med,2012,79(Suppl 2):S8-S13.
[30]SAMA,PREZ-LOPEZ C,ROMAGOSA J,et al.Dyskinesia and motor state detection in Parkinson's disease patients with a single movement sensor[J].Conf Proc IEEE Eng Med Biol Soc,2012,2012:1 194-1 197.
[31]RAJABALLY Y A,MARTEY J.Levodopa,Vitamins,ageing and the neuropathy of Parkinson’s disease[J].J Neurol,2013,260(11):2 844-2 848.
[32]MCCADDON A.Vitamin B12in neurology and ageing:Clinical and genetic aspects[J].Biochimie,2013,95(5):1 066-1 076.
[33]SHEN L.Association beweeten B Vitamins and Parkinson’s disease[J].Nutrients,2015,7(9):7 190-9 208.
[34]HEUMANN R,MORATALLA R,HERRERO M T,et al.Dyskinesia in Parkinson's disease:mechanisms and current non-pharmacological interventions[J].J Neurochem,2014,130(4):472-489.