A Study Of Relationship Between Blood Serum Prolactin Level And Parkinson's Disease With Dementia

PrefaceDementia affects around 7% of the general population older than 55 years , and30% of people older than 80 years. It is predicted that the prevalence rate will increaseby one time in the future 30 years. In every country in the world , the cognitive disorderhas become a prior content of medical treatment and social security social healthservice in the present of severe condition of the social ageing.Parkinson's disease (PD) is one of the most common denaturation disease ofnervous system in the middle age people and the elderly. The recent research manifeststhat obvious dementia can occur in the Parkinson's disease patients, which is calledParkinson's disease with dementia (PDD). Owing to this disease affects the dopaminepathway of both frontal lobe and limbic system of the PD patients, so they alwaysaccompany with dementia symptom, which is the important factor leading to thetherapy compliance decrease and affecting quality of life in the PD patients.PRL is the endocrine hormone secreted by the hypothalamic-pituitary-gonadal(HPG) axis. the secretion of PRL is controlled by dopaminergic neuron / serotonergicneuron (DA/5-HT).So the secretion of PRL can indirectly reflect the dynamic changeof DA/5-HT level, while the DA/Ach is another pair of balance transmitters,.The 5-HTand Ach stimulate the release of PRL.The purpose of this study is to discuss the relationship between the level of PRLand PDD Objective and method1．Objective(1) Case groupWe collect patients who are males older than 55 years and menopause femalesvisiting the out-patient clinic(OPD) of department of neurology of the first affiliatedhospital of china medical university from Nov. 2005 to Oct.2006,and select 30 cases ofPD without dementia and 30 cases of PD with dementia. All the selected cases areconsistent with the clinical diagnostic criteria of the PD and PDD. The admissionstandard of the case group excludes errors brought by diseases and drugs(hypophysoma , hypofunction of anterior lobe of hypophysis, the use of glucocorticoid,endocrine disease of gynecology,some drugs for example levodopa, Bromocriptine,dopamine) affecting PRL or/and HPG axis as far as possible(2) Normal control group30 cases of healthy people who are older than 55 years making the bodyexamine in the health examination center of he first affiliated hospital of china medicaluniversity in the same period.2．Method(1) PRL measurementAll the objects are informed to stop drug intake for 24 hours and fasting for eighthours before haemospasia.We draw blood 3ml at eight o'clock AM which collected byEDTA tube and send it to the endocrine lab of the first affiliated hospital of chinamedical university to measure the serum PRL level. The instruments we used are totalautomatic hormone-measure instrument produced by Bell company of Germany(2) Scale assessment:The patients of PD and PDD is given the assessment of MMSE(mini-mental stateexamination).The MMSE limit score is according to culture degree, illiterate<19elementary school<22 junior high school and higher degree <26．The limit score of dementia is equal to the limit score of culture degree himself subtracting two. If theperson's score is lower than the limit score of dementia, we define him or her asdementia , otherwise he or she belong to the non-dementia group.(3) Statistics analysis of dataWe perform the statistics analysis by using the SPSS,version11．5．The data arepresented with mean (?) standard deviation ((?) (?) S).All the measurement data are analyzedby the t-test and linear correlation analysis,with the p value less than 0．05 as an indication ofinter-group differences with statistics significanceResult1．The comparison between common data and MMSEcomparison between case group and control group, there is no significantdifference(P>0．05) in the aspects of gender construction,age,culture degree averageeducation time. Comparison among the PDD group,PD group and normal controlgroup have significant differences(P<0．05) in the subprogram of MMSE, such as placeorientation,time orientation,attention and calculation ability,short-range memory,writing ability,construction ability.2．The comparison among PDD group,PD group and control group inPRL level and MMSE scoreThe serum PRL level in PDD group is obviously lower than PD without dementiagroup and control group, and the differences are significant (P<0．05) . The serum PRLlevel in PD without dementia group is also lower than the control group (P<0．05) TheMMSE score of PDD group is obviously lower than normal control group and PDgroup (P<0．05) , and the differences are significant.3．The relationship between serum PRL level and MMSE score inPDD groupSerum PRL level and MMSE score have high correlation in PDD group. The result shows that the more severe dementia symptom in PDD patients is , the lowerserum PRL level is.Conclusion1．The serum PRL level in PDD patients is decreased.2．The more severe dementia symptom in PDD patients is , the lowerserum PRL level is, and they have high correlation.