帕金森病非运动症状的临床分析

Clinical analysis on non-motor symptoms in Parkinson's disease

目的研究帕金森病(PD)非运动症状的各项发生率及其与临床资料的关系。方法对71例确诊为帕金森病的患者进行非运动症状问卷(non-motor symptom quest,NMSQ)及统一帕金森病评定量表(unified Parkinson's disease rating scale,UPDRS)评估和相关信息登记,研究各项发生率、总发生数特点及其与病程、年龄、H-Y分期、性别、药物剂量等可能因素间的关系。结果 98.59%的PD患者伴有NMS,以记忆力下降(70.4%)、便秘(67.6%)和注意力下降(66.2%)为最常见。PD患者NMS发生数平均为(11.50±4.95)项;轻度患者NMS发生数为(8.14±3.88)项,中度患者NMS发生数为(12.89±4.08)项,二者间差异有统计学意义(t=-4.75,P<0.001)。重度患者NMS发生为(17.85±3.24)项。PD患者非运动症状发生数与患者年龄(r=0.301,P=0.01)、病程(r=0.463,P<0.001)、H-Y分期(r=0.664,P<0.001)、UPDRS总分(r=0.545,P<0.001)呈正相关。结论非运动症状普遍发生在PD患者中,认知障碍及便秘、睡眠障碍发生率较高。非运动症状发生数与PD的严重程度相关。应重视PD患者的非运动症状,给予积极干预和治疗。

Objective To investigate the incidence of non -motor symptoms （NMS） in patients with Parkinson＇s disease（PD） and its relationship with clinical features. Methods Totally 71 PD patients were evaluated by NMS questionnaire and Unified Parkinson＇s Disease Rating Scale. The patients＇ clinical information was recorded. The prevalence of each item, the total NMS numbers and their relationships with clinical features were assessed. Results 98.59% PD patients with NMS had decreased recent memory （70.4%）, constipation （67. 6% ） , and decreased attention（66.2% ）. NMS Quest average score of the PD was （11.50 ±4.95 ） ; NMS Quest average score of the moder- ate PD disease group （12.89 ± 4.08）was significantly higher than that of the mild group （8.14 ±3.88） （P 〈 0.001 ）. NMS Quest average score of the severe group was （17.85 ±3.24）. In addition, NMS was positively correlated with age（r = 0. 301 ,P = 0. O1 ）, duration（r = 0. 463,P〈0.001）, H-Y stage（r= 0.664,P〈0.001） and UPDRS score（r =0.545,P〈0.001）. Conclusion Non-motor symptoms are common among PD patients. The cognitive impairment, constipation and sleep disorder show highest rate of occurrence. The total number of NMS is correlated with the severity of PD. More attention should be paid to the diagnosis and treatment with NMS in PD.