Jellinger Kurt A
Institute of Clinical Neurobiology, Kenyongasse 18/7, 1070 Vienna, Austria.
Acta Neuropathol. 2003 May;105(5):415-9. doi: 10.1007/s00401-003-0676-3. Epub 2003 Feb 19.
Data on the relationship between Parkinson's disease (PD) and stroke have been conflicting, some studies showing a reduced risk of stroke during life, and others indicating an increased risk of stroke-related death. Consecutive cases (n=617) of autopsy-proven idiopathic PD (Lewy body disease of the brain stem type) and age-matched controls (n=535) were compared using current routine and immunohistochemical methods. The total frequency of cerebrovascular lesions (lacunes, amyloid angiopathy, white matter lesions, old and recent ischemic infarcts and hemorrhages) in PD (44.0%) was higher than in controls (32.8%), while acute, often fatal ischemic or hemorrhagic strokes were less frequent in parkinsonian patients (1.8% vs 2.6%). Like previous postmortem findings in a smaller cohort, these findings neither indicate a protective effect against stroke nor a greater susceptibility to death from stroke in the populations studied. Cognitive impairment in PD appears to be largely independent from coexistent vascular pathology except in cases with severe cerebrovascular lesions.
帕金森病（PD）与中风之间关系的数据存在矛盾，一些研究表明一生中中风风险降低，而另一些研究则表明中风相关死亡风险增加。使用当前的常规和免疫组化方法，对经尸检证实的特发性PD（脑干型路易体病）连续病例（n = 617）和年龄匹配的对照组（n = 535）进行了比较。PD患者脑血管病变（腔隙性梗死、淀粉样血管病、白质病变、陈旧性和近期缺血性梗死及出血）的总发生率（44.0%）高于对照组（32.8%），而帕金森病患者急性、常致命的缺血性或出血性中风发生率较低（1.8%对2.6%）。与之前在较小队列中的尸检结果一样，这些发现既未表明对中风有保护作用，也未表明在所研究人群中对中风死亡更易感性。除了严重脑血管病变的病例外，PD患者的认知障碍似乎在很大程度上与共存的血管病理无关。
