Semchuk K M, Love E J, Lee R G
Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Canada.
Neurology. 1993 Jun;43(6):1173-80. doi: 10.1212/wnl.43.6.1173.
We studied the relative etiologic importance upon the development of Parkinson's disease (PD) of occupational exposure to herbicides and other compounds, ionizing radiation exposure, family history of PD and essential tremor, smoking, and history of various viral and other medical conditions. We identified patients (n = 130) with neurologist-confirmed idiopathic PD through contacts with Calgary general hospitals, long-term care facilities, neurologists, the Movement Disorder Clinic, and the Parkinson's Society of Southern Alberta, and selected two matched (by sex and age +/- 2.5 years) community controls for each case by random digit dialing. We obtained lifetime work, chemical, radiation, medical, and smoking exposure histories and family histories of PD and essential tremor by personal interviews, and analyzed the data using conditional logistic regression for matched sets. After controlling for potential confounding and interaction between the exposure variables, using multivariate statistical methods, having a family history of PD was the strongest predictor of PD risk, followed by head trauma and then occupational herbicide use. Cases and controls did not differ in their previous exposures to smoking or ionizing radiation; family history of essential tremor; work-related contact with aluminum, carbon monoxide, cyanide, manganese, mercury, or mineral oils; or history of arteriosclerosis, chicken pox, encephalitis, hypertension, hypotension, measles, mumps, rubella, or Spanish flu. These results support the hypothesis of a multifactorial etiology for PD, probably involving genetic, environmental, trauma, and possibly other factors.
我们研究了职业接触除草剂及其他化合物、电离辐射暴露、帕金森病（PD）家族史和特发性震颤、吸烟以及各种病毒感染病史和其他疾病史对帕金森病发病的相对病因学重要性。我们通过与卡尔加里综合医院、长期护理机构、神经科医生、运动障碍诊所和阿尔伯塔南部帕金森病协会联系，确定了130例经神经科医生确诊的特发性PD患者，并通过随机数字拨号为每个病例选取了两名匹配的（按性别和年龄，±2.5岁）社区对照。我们通过个人访谈获取了患者一生的工作、化学物质、辐射、医疗和吸烟暴露史以及帕金森病和特发性震颤的家族史，并使用条件逻辑回归对匹配组数据进行分析。在控制了暴露变量之间的潜在混杂因素和相互作用后，采用多变量统计方法，帕金森病家族史是帕金森病风险的最强预测因素，其次是头部创伤，然后是职业性除草剂使用。病例组和对照组在既往吸烟或电离辐射暴露、特发性震颤家族史、与铝、一氧化碳、氰化物、锰、汞或矿物油的工作相关接触，或动脉硬化、水痘、脑炎、高血压、低血压、麻疹、腮腺炎、风疹或西班牙流感病史方面没有差异。这些结果支持了帕金森病多因素病因学的假说，可能涉及遗传、环境、创伤以及其他可能的因素。
