帕金森病非运动症状相关性的研究

Cross-validation between non-motor symptoms and motor symptoms in Parkinson＇ s disease

目的 探讨帕金森病（PD）患者非运动症状（NMS）中抑郁、自主神经功能、认知功能、嗅觉、快速动眼睡眠障碍评分之间及其与运动症状的相关性.方法 采用PD综合评分量表（UPDRSⅢ）对44例原发性PD患者的运动症状进行评估；同时采用简易智力状况检查量表（MMSE）、17项汉密尔顿抑郁量表（HAMD-17）、PD自主神经功能量表（SCOPA-AUT）、睡眠障碍（RBD）量表和史尼芬16项嗅觉筛查量表（SS-16）对患者的NMS进行评分,与12例对照组比较,统计NMS之间及其与UPDRSⅢ之间的相关性.结果 PD组患者嗅觉障碍、抑郁程度、自主神经功能、快速动眼睡眠障碍均较对照组严重（P＜0.01）,而MMSE的评分比较差异则无统计学意义（P=0.804）.此外,在PD组中,HAMD-17评分（r=0.447,P=0.004）、SCOPA-AUT评分（r=0.360,P =0.023）与UPDRSⅢ呈明显正相关；而在NMS之间SCOPA-AUT与RBD评分呈正相关（r =0.331,P =0.035）；HAMD-17与MMSE评分呈明显负相关（r=-0.460,P=0.003,）；与SCOPA-AUT呈正相关（r=0.394,P=0.011）.结论 NMS已经成为影响PD患者生活质量的重要因素.NMS常伴随发生,其中抑郁、自主神经功能紊乱程度与运动症状的严重程度密切相关；自主神经功能紊乱与睡眠障碍的发生有一定相关性；PD患者抑郁的程度与其认知障碍和自主神经功能紊乱程度一致.

Objective To explore the cross-validation between non-motor symptoms（depression,autonomic function,cognitive function,olfactory function and assessment of REM sleep behavior disorder） and motor symptoms in Parkinson＇s disease（PD）.Methods Motor symptoms of 44 PD patients were assessed with UPDRSⅢ.The mini-mental state examination （MMSE）,the 17-item Hamilton Rating Scale for Depression （HAMD-17）,SCOPA-AUT Scales for Outcomes in Parkinson＇s disease-Autonomic,REM sleep behavior disorder（RBD） and 16-item odor identification test from Sniffin＇ Sticks（SS-16） were applied to study non-motor symptoms in PD patients and 12 healthy controls.Results A significant difference（P 〈 0.01） was achieved between controls and patients in the assessment of olfactory function by SS-16 scores,severity of depression by the HAMD-17 and automalic function by SCOPA-AUT and RBD scores although there was no significant difference in their MMSE （P =0.804） ; In addition,in PD patients,HAMD-17 （r =0.447,P =0.004） and SCOPA-AUT （r =0.360,P =0.023） were significantly positively related with the severity of PD.Furthermore,MMSE scores were decreased with severity of depression（r =-0.460,P =0.003） ; In addition,autonomic function was positively related to HAMD-17 （r =0.394,P =0.011）.Conclusion NMS has become one of the important factors affecting the quality of life in PD.NMS are usually accompanied by each other; Depression and dysfunction of autonomic function are closely associated with progression of PD;RBD is related to autonomic function either.In addition,depression in PD is consistant with cognitive impairment and dysfunction of autonomic function.