早中期帕金森病患者眼部症状的临床分析

Clinical analysis of ocular symptoms of patients with early and middle stage Parkinson's disease

目的研究早中期帕金森病患者的眼部症状及其临床意义。方法利用视频眼震电图(VNG)对24例原发性帕金森病(PD)患者(PD组)进行眼球扫视功能测试并观察眨眼动作,记录治疗前后的扫视潜伏期、扫视精确度和眨眼频率,以24名年龄、性别相匹配的健康者作为对照组。结果在PD组和对照组,扫视潜伏期分别为(292.18±50.51)ms和(237.40±32.78)ms,扫视精确度分别为89.51±10.59和96.69±11.00,眨眼频率分别为(13.21±7.55)次/min和(20.04±6.56)次/min;在PD组接受治疗的患者(n=19),用药前后扫视精确度分别为90.36±11.09和92.98±10.18,眨眼频率分别为(12.58±7.91)次/min和(16.63±6.98)次/min。统计学分析结果显示:与对照组比较,PD组扫视潜伏期显著延长(P<0.01),扫视精确度和眨眼频率显著下降(P<0.05,P<0.01);服药后PD组扫视精确度和眨眼频率较服药前显著提高(P<0.05,P<0.01),且与对照组比较差异无统计学意义(P>0.05)。结论 PD患者的眼球扫视运动和眨眼功能明显异常,可作为PD早期诊断的参考指标;抗PD药物治疗可改善PD患者的眼部症状。

Objective To investigate the ocular symptoms of patients with early and middle stage Parkinson＇s disease （PD） and its clinical significance. Methods The videonystagrnography （VNG） was used to perform ocular saccade function examination and observe eye blinks for 24 patients with idiopathic Parkinson＇s disease （PD group）. The latency of saccades, accuracy of saccades, and blink rates before and after treatment were recorded. Another 24 healthy people with similar age and gender were selected as controls （control group）. Results For the PD group and control group, the latency of saccades was （292.18 ±50.51） ms and （237.40 ± 32.78） ms, the accuracy of saccades was 89.51 ±10.59 and 96.69±11.00, and the blink rates were 13.21 ± 7.55 times and 20.04 ±6.56 times per minute. For patients of the PD group who underwent treatment （n =19）, the accuracy of saccades was 90.36 ±11.09 and 92.98±10.18 and the blink rates were 12.58±7.91 times and 16.63 ±6.98 times per minute before and after taking medicines. Results of statistical analysis showed that compared with the control group, the latency of saccades of the PD group significandy prolonged （P〈0.01） and the accuracy of saccades and blink rate significandy decreased （P〈0.05, P〈0.01）. For the PD group, the accuracy of saccades and blink rate after taking medicines significantly improved （ P 〈 0.05, P 〈 0.01 ） and compared with the control group, the differences were not statistically significant （P〉0.05）. Conclusion The ocular saccade and blink rate of patients with PD were markedly abnormal and can be used as reference indexes for the early diagnosis of PD. Anti-PD drug treatment can relieve ocular symptoms of patients with PD.