帕金森病非运动症状的临床特点及其影响因素

Clinical characteristics and influential factors of non -motor symptoms in Parkinson＇s disease

目的通过研究帕金森病（PD）非运动症状（NMS）的发生率，探讨其与PD的病程、病情的关系及其对生活质量的影响。方法对116例PD患者（PD组）和60例健康人（正常对照组）进行NMS问卷调查，比较PD组和正常对照组NMS的发生率，并对PD患者进行Hoehn—Yahr（H—Y）分期、统一帕金森病评定量表（UPDRS）Ⅲ评分、MoCA评分，分析其与NMS的相关性。结果PD组伴NMS者98例（84．48％）；PD组NMS总数平均（12．16±4．37）个，明显高于正常对照组[（5．25±3．06）个]（P〈0．05）。PD组NMS发生率最高的为便秘（72．4％），其次为兴趣减退（69．8％）、近事记忆困难（66．4％）、情绪低落（62．1％）、不宁腿（61．2％）。PD组NMS总数与UPDRSBI评分（r=0．459，P〈0．01）、H—Y分期（r=0．376，P〈0．01）呈正相关，与MoCA评分呈负相关（r=-0．584，P〈0．01）。结论PD患者的NMS发生率高，影响其生活质量，需要重新认识，提高对NMS的判断力，尽早发现和干预。

Objective To investigate the incidence of non- motor symptoms （NMS） in patients with Parkinson＇s disease （PD） , and to discuss its relationship with disease severity, duration and quality of life. Methods A total of 116 PD patients （group PD） and 60 healthy subjects （normal control） were assessed using the NMS questionnaire （NMS Quest）. Then the two groups were compared for the incidence of NMS, while PD patients were scored for Hoehn -Yahr （ H - Y） stage, the United Parkinson＇s Disease Rating Scale （UPDRS） part Ⅲ and MoCA scale to analyze its correlation with NMS. Results 98 cases （84.48%） of NMS were determined in group PD. The mean score of NMS Quest was 12. 16 ± 4.37 in group PD, which was significantly higher than that in the control group （5.25 ± 3.06 ） （ P 〈 0. 05 ）. The highest incidence of NMS was constipation （72.4%）, followed by lost interest （69.8%）, recent memory impairment （66.4%）, depression （62.1%）, and restless legs syndrome （61.2%）. According to the number of NMS in group PD, there was a positive correlation between the occurrence of NMS and UPDRS IH scores （r = 0. 459, P 〈0.01 ） and H - Y stage （r = 0. 376, P 〈 0.01 ） , as well as a negative correlation between the occurrence of NMS and MoCA scores （ r = - 0. 584, P 〈 0.01 ）. Conclusion NMS is frequently seen in PD patients, influencing their quality of life. There are great needs to strengthen our awareness toward NMS and the capacity to diagnose, taking actions to intervene and treat as early as possible.