摘要： 目的 通过观察脑深部电刺激术后帕金森病患者外周血淋巴细胞数目的变化，探讨其治疗机制。方法 测量不同处理组受试者外周血淋巴细胞数目，并与性别、年龄、病程、统一帕金森病评价量表（UPDRS）Ⅲ评分、Hoehn-Yahr分级及药物种类和日等效剂量等因素进行相关分析。结果（1）与正常对照组相比，非手术组帕金森病患者外周血淋巴细胞数目减少（P = 0.000），与UPDRSⅢ评分呈负相关（r_s = - 0.403，P = 0.031），与性别、年龄、病程、Hoehn-Yahr 分级及药物种类和日等效剂量无关联性（均P >0.05）。（2）手术组帕金森病患者外周血淋巴细胞数目与正常对照组相近（P = 0.137），与各项临床指标之间均无关联性（P > 0.05）。（3）与手术组帕金森病患者相比，非手术组患者外周血淋巴细胞数目减少（P = 0.006）；Hoehn-Yahr 分级相同时，两组外周血淋巴细胞数目差异有统计学意义（2.5 级：Z = - 2.197，P = 0.043；3 级：Z = - 1.875，P = 0.027；4 级：Z = - 3.760，P = 0.016）。结论 帕金森病患者外周血淋巴细胞数目呈特异性改变，可能为疾病本身表现，与中枢神经系统免疫炎症反应有关。脑深部电刺激术可能可以减轻中枢神经系统免疫炎症反应。

关键词: 帕金森病, 电刺激疗法, 丘脑底核, 淋巴细胞

Abstract: Objective To study the changing in number of peripheral blood lymphocyte (PBL) of patients with Parkinson's disease (PD) after deep brain stimulation (DBS), and to explore the mechanism of DBS in treating PD. Methods One hundred and thirty PD patients were divided into 2 groups, namely, non-DBS group [N = 105; 68 males and 37 females; mean age (61.54 ± 10.44) years; mean duration (7.29 ± 4.57) years], and DBS group [N = 25; 16 males and 9 females; mean age (59.20 ± 10.67) years; mean disease duration (12.16 ± 4.79) years]. There were 73 healthy subjects [37 males and 36 females; mean age (61.89 ± 12.20) years] in control group. The differences of the number of PBL among the 3 groups were analyzed. Spearman's rank correlation analysis was used to assess the relationship between PBL number and influenzing factors [gender, age, disease duration, Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ score, Hoehn-Yahr (H-Y) stage, and drug equivalent daily dose]. Results The number of PBL in non-DBS group was less than that in control group (P = 0.000). There was significant correlation between UPDRS Ⅲ and PBL number (r_s = - 0.403, P = 0.031). No correlation was found between PBL number and gender, age, disease duration, H-Y stage or drug equivalent daily dose (P > 0.05, for all). No difference was shown between PBL number in control group and in DBS group (P = 0.137) and no correlations were found with clinical variables (P > 0.05). The PBL number in non-DBS group was less than that in DBS group (P = 0.006). With the same H-Y stage, PBL number in non-DBS group was also less than that in DBS group in Mann-Whitney U test (H-Y 2.5: Z = - 2.197, P = 0.043; H-Y 3: Z = - 1.875, P = 0.027; H-Y 4: Z = - 3.760, P = 0.016). Conclusion The changing in the number of PBL is the specific feature of PD and may be correlated with the immuno-inflammation of central nervous system, which may be relieved by DBS.

Key words: Parkinson disease, Electric stimulation therapy, Subthalamic nucleus, Lymphocytes