Marttila R J, Rinne U K
Clin Neurol Neurosurg. 1976;79(1):46-56. doi: 10.1016/s0303-8467(76)80005-4.
A case-control study was performed to investigate the significance of arteriosclerosis, heredity and some infections in the etiology of Parkinson's disease. The study group consisted of all traceable patients with Parkinson's disease living in a defined area, a total of 444 patients, and of control subjects for each patient, matched in sex and age, chosen from among the general population residing in the same area. No significant differences were found between the patients and the controls concerning the occurrence of cardiac insufficiency, coronary heart disease, or stroke. The Parkinsonian patients, however, had a significantly lower incidence of clinical arterial hypertension when compared with the controls. In addition, the patients more often had low systolic blood pressures and more rarely high pressures than the controls. Even the mean systolic blood pressure was significantly lower in the patients than in the controls. The low blood pressure seems to be an effect of Parkinson's disease itself with a minor contribution of levodopa therapy. The observations above are considered to indicate that arteriosclerosis and Parkinson's disease are probably only concurrent disorders and not in etiological relationship with each other. There was no statistically significant difference in the proportion of the patients and the controls with relatives with Parkinson's disease or essential tremor, which suggests that genetic factors do not have a significant role in Parkinson's disease and on the other hand that essential tremor and Parkinson's disease are two separate disease entities. No other encephalitis than a lethargic one was found to precede Parkinson's disease and the occurrence of meningitis was rare both among the patients and the controls. The history of Spanish influenza was found to be as frequent in the patients as in the controls, thus not supporting the idea that influenza has etiological importance in Parkinson's disease.
进行了一项病例对照研究，以调查动脉粥样硬化、遗传因素和某些感染在帕金森病病因学中的意义。研究组由居住在特定区域的所有可追踪的帕金森病患者组成，共444例患者，以及为每位患者从居住在同一区域的普通人群中挑选的性别和年龄相匹配的对照对象。在心力衰竭、冠心病或中风的发生率方面，患者与对照之间未发现显著差异。然而，与对照组相比，帕金森病患者临床动脉高血压的发生率显著较低。此外，与对照组相比，患者收缩压较低的情况更为常见，而高血压的情况则较少见。甚至患者的平均收缩压也显著低于对照组。低血压似乎是帕金森病本身的一种影响，左旋多巴治疗的影响较小。上述观察结果被认为表明动脉粥样硬化和帕金森病可能只是并发疾病，彼此之间不存在病因学关系。患者和对照组中患有帕金森病或特发性震颤亲属的比例在统计学上没有显著差异，这表明遗传因素在帕金森病中没有显著作用，另一方面也表明特发性震颤和帕金森病是两种不同的疾病实体。除了昏睡性脑炎外，没有发现其他脑炎先于帕金森病出现，并且脑膜炎在患者和对照组中的发生率都很低。发现西班牙流感病史在患者和对照组中同样常见，因此不支持流感在帕金森病病因学中具有重要意义的观点。
