帕金森病患者非运动症状的发生状况及影响因素

Prevalence and its impacting factors of non-motor symptoms in Parkinson＇s disease

目的 研究帕金森病（PD）非运动症状（non-motor symptoms,NMS）的各项发生率、发生数及可能影响因素.方法 对131例门诊确诊为PD的患者进行NMS问卷（NMSQuest）调查,研究各项发生率、总发生数的状况及其与各种可能因素间的关系.结果所有入组PD患者均有NMS,分布于PD的各个阶段,平均每例患者有11项NMS;各项发生率中以自主神经症状如夜尿、便秘等的发生率最高,入组年龄≥65岁患者组在嗅觉减退、吞咽困难和便秘等多项发生率上高于＜65岁组,强直-少动型患者在抑郁相关项目上发生率高于震颤型患者;NMS发生数与病程、患者入组年龄、统一帕金森病评定量表（UPDRS）总分和Hoehn-Yahr（H-Y）分级呈正相关.结论 NMS普遍存在于各期的PD患者,各项发生率随PD患者的临床特点不同而变化,NMS发生数与PD的疾病严重程度呈正相关,应提高对NMS诊断和合理治疗的重视.

Objective To explore the incidence rate, total incidence numbers and possible impacting factors of non-motor symptoms （NMSs） in Parkinson＇s disease （PD）. Methods The NMS questionnaire （NMS Quest） was used to investigate 131 out-patients diagnosed with PD, and the prevalence of each item, the total NMS numbers and their relationships with clinical features were assessed. Results All of the patients, who were distributed in every stage of PD, had NMSs and each case with 11 items on average. Autonomic symptoms such as nocturia and constipation were the most frequent ones. The patients over 65 versus less than 65 years old had a higher prevalence in a number of items such as olfactory disturbance, dysphagia and constipation. At the same time, the rigidity subtype patients had a higher prevalence in depression items than the tremor subtype ones.The total number of NMS was positively correlated with course of disease, age, UPDRS score and Hoehn ＆ Yahr （H＆Y） stage. Conclusions NMSs are common among PD patients. While the prevalence of each item may vary with different clinical features, the total number of NMS is increased with the severity of PD. More attention should be paid to the diagnosis and rational treatment of the NMSs.