帕金森病患者非运动症状的研究

Clinical study on non-motor symptoms of Parkinson disease

目的调查帕金森病（PD）非运动症状的发生和分布情况及其与PD严重程度、病程之间的关系。方法应用统一PD评分量表（UPDRS）的第Ⅲ、V部分、PD非运动症状30问卷量表（the PD NMS questionnaire，NMSQuest）、日常生活能力量表（ADL）和简易智能量表（MMSE）评分，对81例原发性PD患者的运动症状和非运动症状进行了评估，并将结果与国外的相关研究结果进行比较。结果非运动症状在PD病程各个时期均可出现，平均每个PD患者出现7项左右不同的非运动症状，以记忆力障碍、便秘和夜尿增多的发生率最高。并且非运动症状的发生与PD疾病的进展相关，与Hoehn and yahr（H-Y）分级呈正相关（rs=0．360，P〈0．01），与UPDRSⅢ运动评分呈正相关（rs=0．336，P〈0．01），且影响患者的生活质量，与ADL评分呈负相关（rs=0．250，P〈0．05）；而与年龄、性别、病程、PD发病类型和左旋多巴。每日治疗量无相关性。（分别为rs=0．193、rs=0．142、rs=-0．053、rs=0．017和rs=0．195，均为P〉0．05）结论非运动症状的发生在PD中很普遍，对生活质量的影响不比运动症状轻，需要全面认识和及时干预。

Objective This study was designed to survey the prevalence, distribution of non-motor symptoms （NMS） in Parkinson disease （PD） and their relationship with disease severity and duration. Methods We used Unified Parkinson Disease Rating Scale（UPDRS） part Ⅲ, V, the PD NMS Questionnaire, activities of daily living （ADL） and mini-mental state examination （MMSE） to assess motor and non-motor symptoms in 81 patients with Parkinson disease. Results In PD, a range of NMS occurred across all disease stages. Each PD patient had 7 different NMS on average. The problems of remembering thing, constipation and nocturia ranked top 3 of NMS in patients with PD. There was a significant association of total NMS score with H-Y stage（P〈0.01） and UPDRS III score（P〈0.01）. There was a negative correlation between NMS score and ADL score（P〈0.05）, but no relationship of total NMS score was found with disease age, duration, sex distribution, daily dose of L-dopa or subtype of PD. Conclusions NMS in PD are common and frequent. PD-NMS affect patients＇ quality of life, just like motor symptoms, and should be well recognized and treated.