帕金森病患者自主神经功能障碍评估

Assessment of Autonomic Dysfunction in Patients with Parkinson's Disease

目的:评估帕金森病(PD)患者中自主神经功能障碍症状发生比例、各症状分布的差异,及其与PD临床特点之间的关系。方法:应用SCOPA-AUT量表、统一帕金森病评分量表(UPDRS)、日常生活能力量表(ADL)、Hamilton抑郁量表和简易智能量表(MMSE)对116例原发性PD患者进行评估。结果:SCOPA-AUT总分和消化系统(GI)症状、排尿(UR)症状、体温调节(TH)症状、性功能(SX)症状评分均高于对照组,差异有极显著统计学意义(P=0.0001)。SCOPA-AUT总分与UPDRS评分、Hamilton抑郁量表评分呈正相关(P<0.001),与生活质量ADL评分呈负相关(P<0.001)。结论:自主神经功能障碍在PD早期就会出现,并随着疾病进展而加重,影响患者的生活质量。

Aim： To investigate the prevalence,distribution of autonomic dysfunction in patients with Parkinson＇s disease（PD）, and to analyze the relationship between these symptoms and disease-related characteristics. Methods： The Scale for Outcomes in PD for Autonomic Symptoms（SCOPA-AUT）, Unified Parkinson＇s Disease Rating Scale（UPDRS）, Activity of Daily Living Scale（ADL）, Hamilton Depression Rating Scale for Depression（HRSD） and Mini-mental State Examination （MMSE） were used to evaluate 116 patients with idiopathic PD. The results were taken from PD patients and compared with those of 80 control subjects. Results： PD patients had more total SCOPA-AUT score and domain scores in gastrointestinal, urinary, thermoregulatory and sexual symptoms compared to control subjects（P = 0.000 1）. All scores increased significantly with developing disease severity except thermoregulatory function. There were significant positive correlations between the total score with UPDRS or HRSD, and negative correlation with ADL（P〈0.001）. The total score of 16 novo PD patients without treatment higher than that of controls（P=0.000 8）, especially on region thermoregulatory（P=0.000 6）. There was no relationship among the total score and dose of levodopa, disease duration and sex. Conclusion： Autonomic dysfunction is an important feature of Parkinson＇s disease, being present early in the disease and increasing with disease severity. It impacts the patients with PD on daily life and functioning quality.