Lieberman Abraham, Lyons Kelly, Levine Jay, Myerburg Robert
Department of Neurology, University of Miami School of Medicine, Miami, FL 33136, USA.
Parkinsonism Relat Disord. 2005 Mar;11(2):81-4. doi: 10.1016/j.parkreldis.2004.07.012.
'Statins', drugs that lower cholesterol are widely used. Statins block cholesterol in the body and brain by inhibiting HMG-Co-A reductase. This pathway is shared by CoQ-10. An unintended consequence of the statins is lowering of CoQ-10. As CoQ-10 may play a role in PD, its possible statins may worsen PD. Such a report has appeared. Statins came into wide use in 1997-1998, 6 years before our study began. Thus 74% of our patients on a statin had a PD duration of 1-6 years versus 56% of our patients not on a statin. A direct comparison of patients on a statin and not on a statin would bias the study in favor of the statins: patients on a statin would have a shorter disease duration and less advanced PD. Therefore we divided the patients into two groups. Group I consisted of 128 patients on a statin, and 252 not on a statin who had PD for 1-6 years. In this group, disease severity (Hoehn & Yahr Stage), levodopa dose, Co-enzyme Q10 use, prevalence of 'wearing off', dyskinesia and dementia were similar. Group II consisted of 45 patients on a statin and 200 patients not on a statin who had PD for 7-22 years. In this group disease severity, levodopa dose, Co-enzyme Q10 use, prevalence of wearing off, dyskinesia and dementia were similar. Statins although they may affect Co-enzyme Q10 levels in the body and the brain, do not worsen PD at least as assessed by stage, and prevalence of wearing-off, dyskinesia, and dementia.
“他汀类药物”,即降低胆固醇的药物被广泛使用。他汀类药物通过抑制HMG-Co-A还原酶来阻断体内和大脑中的胆固醇。这条途径与辅酶Q-10是共用的。他汀类药物的一个意外后果是降低辅酶Q-10的水平。由于辅酶Q-10可能在帕金森病中起作用,他汀类药物有可能使帕金森病恶化。这样的一份报告已经出现。他汀类药物在1997 - 1998年开始广泛使用,比我们的研究开始早6年。因此,我们服用他汀类药物的患者中有74%的帕金森病病程为1至6年,而未服用他汀类药物的患者这一比例为56%。直接比较服用他汀类药物和未服用他汀类药物的患者会使研究偏向于他汀类药物:服用他汀类药物的患者病程会更短,帕金森病病情也不那么严重。因此我们将患者分为两组。第一组由128名服用他汀类药物且帕金森病病程为1至6年的患者以及252名未服用他汀类药物的患者组成。在这组中,疾病严重程度(霍恩和雅尔分期)、左旋多巴剂量、辅酶Q10的使用、“剂末现象”的发生率、异动症和痴呆的发生率相似。第二组由45名服用他汀类药物且帕金森病病程为7至22年的患者以及200名未服用他汀类药物的患者组成。在这组中,疾病严重程度、左旋多巴剂量、辅酶Q10的使用、剂末现象的发生率、异动症和痴呆的发生率相似。他汀类药物虽然可能会影响体内和大脑中的辅酶Q10水平,但至少从分期以及剂末现象、异动症和痴呆的发生率评估来看,并不会使帕金森病恶化。