重庆市南川区帕金森病临床特征及诊治现状研究

Clinical features and status quo of Parkinson′s disease diagnosis and treatment in Nanchuan District of Chongqing

目的分析重庆市南川区帕金森病(PD)患者的临床特征及诊治现状,以指导及推广PD规范化治疗。方法选取2016年9月至2017年10月该院收治的120例PD患者的人口学资料和临床资料,了解其临床特征及诊治现状,指导PD规范化治疗,随访其用药依从性。结果120例患者中改良Hoehn and Yahr分期(H-Y分级)3~5级72例(60.00%),流涎、便秘、嗅觉障碍发生率分别为80.00%(98/120)、90.00%(108/120)、80.00%(96/120)。H-Y分级3~5级、左旋多巴联合多巴胺受体激动剂、每天左旋多巴等效剂量大于或等于400mg是患者症状波动的独立危险因素(P<0.05)。120例患者中所用药物为多巴丝肼72例(60.00%)、苯海索30例(25.00%)。经规范化治疗指导后,85.00%(102/121)的患者症状明显改善。70.00%(84/120)的城镇居民服药依从性较好,60.00%(72/120)的农村患者服药依从性较差。结论重庆市南川区多数PD患者既往未能接受规范化治疗,运动症状较重,非运动症状发生率较高。经规范化治疗后患者症状改善明显,但部分患者服药依从性较差,需长期随访及督促。

Objective To analyze the clinical features and status quo of diagnosis and treatment in the patients with Parkinson′s disease(PD)in Nanchuan District of Chongqing City so as to guide and promote the standardized treatment of PD.Methods The demographic and clinical data of 120 patients with PD treated in this hospital from September 2016 to October 2017 were selected to understand the clinical features and diagnosis and treatment status quo,guide the PD standardized treatment and follow up the medication compliance.Results Among 120 cases,72 cases(60.00%)were the 3-5 stages of modified H-Y classification.The occurrence rates of salivation,constipation and olfactory dysfunction were 80.00%(98/120),90.00%(108/120)and 80.00%(96/120)respectively.The stage 3-5 of H-Y classification,levodopa combined with dopamine receptor agonists(LD+DAs)and daily levodopa equivalent dose(LEDD)≥400 mg were the independent risk factors for the symptoms fluctuation(P<0.05).Among 120 cases,the current drugs were levodopa and benserazide hydrochloride in 72 cases(60.00%)and benzhexol in 30 cases(25.00%).After standardized treatment guidance,85.00%of the patients(102/120)had significant improvement in symptoms.70.00%of urban patients(84/120)had good medication compliance and 60.00%of rural patients(72/120)had medication poor compliance.Conclusion Most PD patients in Nanchuan District of Chongqing City fail to receive the standardized treatment in the past,the motor symptoms are severe,and the incidence rate of non-motor symptoms is high.After standardized treatment,the symptoms of the PD patients are improved significantly,but partial patients have poor medication compliance and need long-term follow-up and supervision.