不同运动症状的帕金森病非运动症状的临床特点及差异分析

Clinical characteristics and difference analysis of non-motor symptoms of Parkinson′s disease with different motor symptoms

目的探讨不同运动症状的帕金森病非运动症状的临床特点及差异分析。方法回顾性选取2017年1月至2020年12月收治的120例帕金森病患者作为研究对象,按运动症状的不同分为以震颤为主型52例(震颤组)和动作迟缓为主型68例(动作迟缓组),对两组患者的H-Y分期、统一帕金森病评分量表第三部分量表(UPDRS-Ⅲ)、帕金森病睡眠质量表(PDSS)、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、39项生活质量调查问卷(PDQ39)、MMSE量表、MoCA量表、非运动症状出现情况进行比较。结果两组患者H-Y分期比较,差异无统计学意义(P>0.05),动作迟缓组UPDRS-Ⅲ评分、HAMA评分、HAMD评分、PDQ39评分均高于震颤组,差异有统计学意义(P<0.05),动作迟缓组MMSE评分、MoCA评分均低于震颤组,差异有统计学意义(P<0.05)。动作迟缓组患者感觉异常、情感障碍、精神异常、认知损害、多汗发生率高于震颤组患者,差异有统计学意义(P<0.05)。结论非运动症状是帕金森病的常见表现,动作迟缓为主型患者在非运动状态方面比震颤为主型患者病情更加严重,对患者的影响更大,应在临床中引起重视。

Objective To explore the clinical characteristics and differences of non-motor symptoms of Parkinson′ s disease with different motor symptoms. Methods A total of 120 patients with Parkinson′s disease from January 2017 to December 2020 were selected retrospectively as research objects, and they were divided into the tremor group(n=52) and the bradykinesia group(n=68) according to different motor symptoms. The two groups were compared in terms of H-Y stage, Unified Parkinson′s Disease Rating Scale version(3.0)(UPDRS-Ⅲ), Parkinson′s Disease Sleep Scale(PDSS),Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), Parkinson′s disease questionnaires(PDQ39), MiniMental State Examination(MMSE), Montreal Cognitive Assessment(MoCA) and the appearance of non-motor symptoms.Results There was no significant difference in H-Y staging between the two groups(P>0.05). The UPDRS-Ⅲ score,HAMA score, HAMD score and PDQ39 score in the bradykinesia group were higher than those in the tremor group,with statistically significant differences(P<0.05), while the MMSE score and MoCA score in the bradykinesia group were lower than those in the tremor group, with statistically significant differences(P<0.05). The incidence of paresthesia, affective disorder, mental disorder, cognitive impairment and hyperhidrosis in patients with bradykinesia was higher than those in tremor group, with statistically significant differences(P<0.05). Conclusion Non-motor symptoms are common manifestations of Parkinson′s disease. Patients with bradykinesia are more serious than patients with tremor in non-motor state, which have a greater impact on patients, and it should be paid attention to in clinical practice.