高龄帕金森病患者临床特征分析

Analysis of clinical characteristic of elderly patients with Parkinson's disease

目的 探讨高龄帕金森病患者临床特征及诊断治疗策略.方法 对2006年1月～2012年12月收治的78例＞80岁的帕金森病患者与同期69例＜70岁的帕金森病患者的运动障碍症状及受损程度、非运动症状、药物疗效及不良反应和非神经系统并发症进行对比分析.结果 高龄组帕金森病患者运动迟缓、步态姿势异常较对照组重,震颤症状发生率亦低于对照组（均P＜0.05）;高龄组患者运动障碍受损程度高于对照组（P＜0.05）;高龄组患者情感障碍、认知功能障碍（痴呆）、精神症状、自主神经功能障碍等非运动症状发生率高于对照组（P＜0.05）;高龄组帕金森病患者对美多巴试验反应性、药物疗效均较对照组差（均P＜0.05）,药物治疗并发症高于对照组（P＜0.05）;高龄组帕金森病患非神经系统并发症发生率较对照组高（P＜0.05）.结论 高龄帕金森病患者震颤症状不典型,运动迟缓、步态姿势异常较明显,重度运动功能障碍发生率高;非运动障碍症状发生率高;药物治疗反应性较差,不良反应发生率高;非神经系统并发症发生率高.临床诊疗中应注意上述特征,做到及时准确、个体化、合理化治疗.

Objective To investigate the clinical characteristic and diagnosis and treatment of elderly patients with Parkinson＇s disease. Methods 78 Parkinson＇s disease patients older than 80 years and 69 Parkinson＇s disease patients younger than 70 years were involved in the present study. The symptoms of movement disorders, non-motor symptoms, efficacy, adverse drug reaction and non -neurological complications were observed. Results The incidence of bradykine- sia, abnormal gait posture and obstacle of motor function of elderly patients were higher than that of younger patients（P 〈0.05）. The incidence of affective disorder and dementia and psychiatric symptom and autonomic nerve dysfunction of elderly patients were higher than that of the younger group（P〈0.05）. Madopar test reaction and efficacy of elderly pa- tients were worse than that of the control group （P〈0.05）. Drug treatment of complications of elderly patients were higher than that of the control group（P〈0.05）. The incidence of non-neurological complications of elderly patients was higher than the control group（P〈0.05）. Conclusion For elderly patients with Parkinson＇s disease, the tremble symp- tom is not typical. Bradykinesia, abnormal gait posture and obstacle of motor function are more serious. The incidence of non-motor symptoms is high. The response to drug treatment is poor. And the incidence of adverse reactions is high. The incidence of non-neurological complications is high.. We should pay attention to the characteristics in clinical diagno- sis and treatment. Give accurate and timely and individualized, rational and treatment.