帕金森病初诊患者非运动症状的研究

Non-motor symptoms in Parkinson's disease with newly diagnosed

目的:探讨初诊帕金森病(Parkinson’s disease,PD)患者非运动症状(non-motor symptoms,NMS)的发生和分布情况及与PD临床资料和各个量表的关系。方法:收集首次就诊的PD患者61例,在未服用抗PD药物的前提下进行PD基本信息登记和相关量表评估,并与89例正常对照组的NMS相比较。结果:96.7%的PD全组患者伴有NMS,以近记忆力下降(62.3%,38例)、注意力下降(57.4%,35例)、便秘(49.2%,30例)为最常见,与健康对照组均有显著差异(P<0.01)。PD全组NMS(9.1±5.2)、PD中度组NMS(12.2±4.6)和PD轻度组(7.2±3.7)与正常对照组(2.9±2.5)相比有显著差异(P<0.01)。NMSQuest与H-Y分期(rs=0.3,P<0.01)、抑郁自我评定量表(self-rating depression scale,SDS)(rs=0.7,P<0.01)、焦虑自我评定量表(self-rating anxi-ety scale,SAS)(rs=0.7,P<0.01)成正相关;与帕金森睡眠质量量表(Parkinson diseases sleep scale,PDSS)(rs=-0.6,P<0.01)成负相关;与年龄、发病年龄、性别、病程、帕金森统一评分量表Ⅲ评分、蒙特利尔认知功能量表无关。结论:PD初诊患者非运动症状复杂多样,发生率明显高于正常人,故需重视初诊患者的非运动症状,在早期就加以干预和治疗。

Objective： To investigate the incidence and distribution of non-motor symptoms（NMS） in patients with newly diagnosed Parkinson＇s disease（PD）,and its relationship with clinical features and various scales.Methods： Total 61 PD patients without taking any drugs and 89 normal controls were collected in outpatient visits,and their clinic information and related scales were evaluated.Results： 96.7% PD patients with NMS commonly had decreased recent memory（62.3%,38 cases）,decreased attention（57.4%,35 cases）,constipation（49.2%,30 cases）,and there were significant difference between PD group and normal group in those symptoms（P 0.01）.NMSQuest average score of the PD group（9.1 ± 5.2）,moderate PD disease group（12.2 ± 4.6） and mild group（7.2 ± 3.7） were significantly higher than that of the control group（2.9 ± 2.5）（P 0.01）.NMSQuest was positively correlated with H-Y stage（rs = 0.3,P 0.01）,SDS（rs = 0.7,P 0.01） and SAS（rs = 0.7,P 0.01） respectively,and was negatively correlated with PDSS（rs =-0.6,P 0.01）,age,age at onset,gender,duration.UPDRS-Ⅲ score and MOCA were negatively correlated with NMSQuest.Conclusion： NMS in patients with newly diagnosed PD were complex and diverse,and patients with newly diagnosed PD had higher incidence rate than normal control.So we need to pay attention to NMS and treating at the early-stage of PD diseases.