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帕金森病患者血管疾病风险因素降低:一项病例对照研究。

Reduced risk factors for vascular disorders in Parkinson disease patients: a case-control study.

作者信息

Scigliano Giulio, Musicco Massimo, Soliveri Paola, Piccolo Immacolata, Ronchetti Gabriele, Girotti Floriano

机构信息

Istituto Nazionale Neurologico C. Besta, Via Celoria 11, 20131 Milan, Italy.

出版信息

Stroke. 2006 May;37(5):1184-8. doi: 10.1161/01.STR.0000217384.03237.9c. Epub 2006 Mar 30.

Abstract

BACKGROUND AND PURPOSE

Sympathetic hyperactivity is a contributing cause of vascular disorders because it increases blood pressure, blood sugar, and blood lipids. Pervasive compromise of the central and peripheral autonomic nervous systems is common in idiopathic Parkinson disease (IPD) resulting in reduced sympathetic and parasympathetic function. We hypothesized that IPD was associated with reduced prevalence of cardiovascular disease risk factors as a result of reduced sympathetic activity.

METHODS

We performed a retrospective case-control study on 178 newly diagnosed consecutive IPD patients, and 533 age- (+/-3 years) and sex-matched controls with other neurological diseases seen over the same period at the same hospital. For each case and control the following were noted on admission: smoking, diabetes, hypertension, body mass index, serum glucose, plasma cholesterol, triglycerides and total lipid levels, and blood pressure.

RESULTS

Diabetes, history of smoking, high blood pressure, high blood glucose, high blood cholesterol, and triglycerides were significantly less frequent in IPD than controls.

CONCLUSIONS

IDP is a natural model of impaired hypothalamic-pituitary-adrenal axis activity and generalized sympathetic denervation. We interpret the association of untreated IPD with reduced vascular diseases risk factors as attributable to reduced autonomic activity, suggesting that autonomic hyperactivity may be involved in the pathogenesis of vascular disorders.

摘要

背景与目的

交感神经过度活跃是血管疾病的一个促成因素,因为它会升高血压、血糖和血脂。中枢和外周自主神经系统的普遍受损在特发性帕金森病(IPD)中很常见,导致交感神经和副交感神经功能降低。我们假设,由于交感神经活动降低,IPD与心血管疾病危险因素的患病率降低有关。

方法

我们对178例新诊断的连续性IPD患者以及533例年龄(±3岁)和性别匹配的、同期在同一家医院就诊的患有其他神经系统疾病的对照者进行了一项回顾性病例对照研究。对于每例病例和对照者,入院时记录以下信息:吸烟、糖尿病、高血压、体重指数、血糖、血浆胆固醇、甘油三酯和总血脂水平以及血压。

结果

IPD患者中糖尿病、吸烟史、高血压、高血糖、高胆固醇血症和高甘油三酯血症的发生率明显低于对照组。

结论

IPD是下丘脑 - 垂体 - 肾上腺轴活动受损和全身性交感神经去神经支配的天然模型。我们将未经治疗的IPD与血管疾病危险因素降低之间的关联解释为自主神经活动降低所致,这表明自主神经过度活跃可能参与了血管疾病的发病机制。

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