赖洪萍 邵彩庆 黎锦标 孙冉

*基金项目：济宁市重点研发计划项目（2021YXNS082）

【摘要】 帕金森病（Parkinson disease，PD）是老年人群中常见的神经系统退行性疾病，且当前医疗技术水平无法完全治愈，对患者的生存及生活质量造成不可忽视的影响，因此如何延缓PD的进展及改善预后成为当前亟待解决的问题。血浆同型半胱氨酸（homocysteine，Hcy）通过对血管内皮细胞、神经细胞和线粒体的影响及蛋白修饰机制，对PD患者神经系统造成损伤，与PD的严重程度的分期、临床症状和预后相关联。同时也对患者认知功能造成影响。临床通过补充叶酸和B族维生素等可有效降低Hcy。降低PD患者血浆Hcy水平将有利于延缓PD进展和改善PD的症状及预后。本文通过对近年国内外文献的分析综合，对PD和Hcy关系的具体机制进行综述，以期为临床治疗PD提供参考价值。

【关键词】 帕金森病 同型半胱氨酸 综述

Research Progress on the Correlation between Homocysteine and Parkinson Disease/LAI Hongping， SHAO Caiqing， LI Jinbiao， SUN Ran. //Medical Innovation of China， 2024， 21（14）： -168

[Abstract] Parkinson disease （PD） is a common neurological degenerative disease in the elderly population， and the current level of medical technology can not completely cure it， which has an non-negligible impact on the survival and quality of life of patients， so how to delay the progress of PD and improve the prognosis has become an urgent problem to be solved. Plasma homocysteine （Hcy） can damage the nervous system of patients with PD through its effects on vascular endothelial cells， nerve cells and mitochondria and its protein modification mechanism， which is associated with the severity stage， clinical symptoms and prognosis of PD. At the same time， it also affects the cognitive function of patients. Clinical supplementation of folic acid and B vitamins can effectively reduce Hcy. Reducing plasma Hcy level in PD patients will help delay the progression of PD and improve the symptoms and prognosis of PD. Based on the analysis and synthesis of recent domestic and foreign literature， this paper reviews the specific mechanism of the relationship between PD and Hcy， in order to provide reference value for clinical treatment of PD.

[Key words] Parkinson disease Homocysteine Review

First-author's address： School of Clinical Medical， Jining Medical University， Jining 272067， China

doi：10.3969/j.issn.1674-4985.2024.14.039

目前，我国老龄化相对严重，帕金森病（Parkinson disease，PD）作为老年人群中常见的神经系统退行性疾病之一，已成为继心脑血管疾病和阿尔兹海默病（Alzheimer's disease，AD）之后，影响老年人群身心健康的第三大杀手。PD到目前为止是不可治愈的，且患病人数逐年增加，为国家和社会带来不小的负担[1]。研究发现，血浆同型半胱氨酸（homocysteine，Hcy）与PD的进展相关，PD患者血浆中的Hcy含量较正常人显著升高。高血浆Hcy会参与神经细胞的损伤过程，同时影响PD患者的认知功能水平。早期识别及早启动治疗对于改善PD患者的预后有重要意义，降低血浆中Hcy水平也将有望延缓PD患者病情的进展和改善PD患者的神经功能[2]。……