帕金森病患者运动和非运动症状的性别差异

Gender differences in motor and non-motor symptoms among Parkinson's disease patients

目的探讨帕金森病(PD)患者运动和非运动症状的性别差异。方法应用统一PD评分量表(UPDRS)第Ⅲ部分和修订的Hoehn-Yahr(H-Y)分期评定586例PD患者的运动症状。应用PDNMS筛查问卷(NMSQ)评定PD患者及102名正常对照者的非运动症状,并进行比较。结果 PD组男性受教育年限显著长于女性及正常对照组男性(均P<0.05)。PD组男性僵直评分显著高于女性(P<0.05),UPDRS-Ⅲ总分、震颤、运动迟缓、姿势不稳评分及HY分期差异无统计学意义。PD组女性情绪/情感淡漠、其他症状评分及失眠、情绪低落抑郁、焦虑害怕或恐慌、不明原因的疼痛和腿肿胀、增粗的比率显著高于男性(均P<0.05);胃肠道症状、排尿障碍评分及流涎、夜尿增多的比率显著降低(均P<0.05)。正常对照组女性生动梦境、丧失兴趣的比率较正常对照组男性高(均P<0.05)。PD组男性除错觉、恶心或呕吐、大便失禁外,其余各项评分及比率均高于正常对照组男性(均P<0.05);PD组女性除头晕、幻视或幻听、错觉外,其余各项评分及比率均高于正常对照组女性(均P<0.05)。PD组除头晕、大便失禁外,其他评分和各分项的比率均显著高于正常对照组(均P<0.05)。结论 PD患者的运动和非运动症状具有性别差异。

Objective To evaluate gender differences in motor and non-motor symptoms among Parkinson＇s disease （PD） patients.Methods Motor symptoms were assessed by Unified PD Rating Scale Ⅲ （UPDRS Ⅲ） and Modified Hoehn and Yahr （H-Y） staging in 586 PD patients.Non-motor symptoms were evaluated by non-motor symptoms questionnaire scale （NMSQ） in PD patients and 102 normal controls.The results were compared.Results The education year of male in PD group was significantly longer than female in PD group and male in control group （all P 〈 0.05）.The score of rigor in male was significantly higher than that in female in PD group （P 〈 0.05）,and there was no significant difference in the score of UPDRS-Ⅲ,tremor,bradykinesia,instability and H-Y stage.The scores of mood/apathy,miscellany and the rates of insomnia,flat mood and depression,feelings of anxiety or afraid or panic,unexplained pain and legs swelling,thickening were significantly higher in female in PD group than those in male （all P 〈0.05）,while the scores of gastrointestinal,urinary disturbances and the rates of dribbling,nocturia were significantly lower （all P 〈 0.05）.The rates of vivid dreams and loss of interest in female in normal control group were significantly higher than those in male （all P 〈 0.05）.All the scores and rates in male in PD group were significantly higher than those in male in normal control group,except the rates of illusions,nausea or vomiting and fecal incontinence （all P 〈 0.05）.All the scores and rates in female in PD group were significantly higher than those in female in normal control group,except the rates of dizzy,hallucinations and illusions （all P 〈 0.05）.All the scores and rates in PD group were significantly higher than those in normal control group,except the rates of dizzy and fecal incontinence （all P 〈 0.05）.Conclusion There are gender differences in motor and non-motor symptoms among PD patients.