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帕金森病中的遗传学、药物与环境因素。一项病例对照研究。

Genetics, drugs and environmental factors in Parkinson's disease. A case-control study.

作者信息

Werneck A L, Alvarenga H

机构信息

Serviço de Neurologia do Hospital Central do IASERJ, Rio de Janeiro, Brasil.

出版信息

Arq Neuropsiquiatr. 1999 Jun;57(2B):347-55. doi: 10.1590/s0004-282x1999000300001.

Abstract

A case-control study of Parkinson's disease (PD) was conducted in the city of Rio de Janeiro based on the assumption that neurotoxins with secondary parkinsonian action may be related to the development of Parkinson's disease. Ninety-two subjects with PD and 110 controls were queried through a questionnaire in order to investigate possible risk factors for the disease. The following factors were studied: herbicides/pesticides, exposure to chemicals, ingestion of drugs with secondary PD effects, rural life, water well source, family history, cranial trauma and cigarette smoking. Study of mentioned factors was achieved through univariate, stratified and multivariate analyses. Univariate and multivariate analyses demonstrated that PD was positively associated with family history (OR = 14.5; CI = 2.98-91.38), with the use of drugs with secondary PD action (OR = 11.01; CI = 3.41-39.41) and with exposure to chemical agents (OR = 5.87; CI = 1.48-27.23). PD was found to be inversely associated with cigarette smoking (OR = 0.39; IC = 0.16-0.95). Stratified analysis only confirmed family history and drug use, besides demonstrating that cigarette consumption could be a protection factor, when aforementioned factors were involved. This study might be a warning as to the cares that need to be taken regarding drug use and occupational exposure to chemical agents, as both types of substances present secondary PD action.

摘要

在里约热内卢市进行了一项帕金森病(PD)的病例对照研究,其假设是具有继发性帕金森样作用的神经毒素可能与帕金森病的发生有关。通过问卷调查询问了92名帕金森病患者和110名对照者,以调查该疾病可能的危险因素。研究了以下因素:除草剂/杀虫剂、接触化学物质、摄入具有继发性帕金森病作用的药物、农村生活、水井水源、家族史、颅脑外伤和吸烟。通过单因素、分层和多因素分析对上述因素进行研究。单因素和多因素分析表明,帕金森病与家族史呈正相关(OR = 14.5;CI = 2.98 - 91.38),与使用具有继发性帕金森病作用的药物呈正相关(OR = 11.01;CI = 3.41 - 39.41),与接触化学制剂呈正相关(OR = 5.87;CI = 1.48 - 27.23)。发现帕金森病与吸烟呈负相关(OR = 0.39;IC = 0.16 - 0.95)。分层分析仅证实了家族史和药物使用情况,此外还表明,当涉及上述因素时,吸烟可能是一个保护因素。这项研究可能是一个警示,提醒人们在药物使用和职业接触化学制剂方面需要谨慎,因为这两类物质都具有继发性帕金森病作用。

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