中老年人帕金森病与幽门螺杆菌感染的相关性研究

Research on the relationship between Parkinson＆#39;s disease and Helicobacter pylori infection in middle-aged and elderly people

目的 了解帕金森病（PD）患者幽门螺杆菌（HP）的感染情况,分析HP感染与PD症状、病程、运动并发症等的相关性. 方法 在我院门诊随机选取PD患者（PD组）72例,记录基本资料,并进行统一帕金森病评分量表（UPDRS）、Hoehn-Yahr（H-Y）分期、39项PD调查表（PDQ-39）、日常生活活动能力（ADL）、简明精神状态评定量表（MMSE）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）等量表评分,同时选取性别、年龄匹配的健康体检者（对照组）100例,所有入组者做13C-尿素呼气试验. 结果 HP感染率分别为37.5％（27例）和32.0％（32例）,差异无统计学意义（P=0.45）;PD患者根据起始症状不同分组,以强直少动起病者HP感染率52.2％（12例）略高于以震颤起病者30.6％（15例）,但两组差异无统计学意义（P=0.08）;HP感染者的HY分期为（2.6±0.7）期,高于非感染者（2.2±0.9）期（P=0.03）.且H-Y分期≥2期的患者HP感染率46.4％（26例）,高于＜2期的患者6.25％（1例）,差异有统计学意义（P=0.00）.HP感染与PD患者的性别、年龄、发病年龄、UPDRS总分、UPDRS-Ⅲ、PDQ-39、病程、剂末现象、异动症均无相关性. 结论 HP感染以中晚期PD患者为著,HP可能与疾病的进展存在相关性,是否影响运动并发症的产生,需要进一步扩大样本验证.

Objective To investigate the prevalence of Helicobacter pylori （HP） infection in patients with Parkinson＆#39;s disease （PD）, and analyze the relationship of HP infection with the symptoms, disease progression and motor complications of PD.Methods 72 PD outpatients were randomly selected, and 100 gender and age-matched subjects who took health physical examination were considered as healthy controls.Basic data were collected and estimated by Unified Parkinson＆#39;s Disease Rating Scale （UPDRS）, Hoehn and Yahr stage, the 39-item Parkinson＆#39; s Disease Questionnaire （PDQ-39）, Activity of Daily Living Scale （ADL）, Minimum Mental State Examination （MMSE）, Hamilton Depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA）.All subjects underwent 13C-urea breath test to determine Helicobacter pylori infection status.Results There was no significant difference in H P infection rate between PD and control groups [37.5 % （27 cases）vs.32.0% （32 cases）, P=0.45].According to the initial symptoms, PD patients were divided into two groups： bradykinesia/ rigidity group and tremor group.The HP infection rate was higher in bradykinesia/rigidity group than in tremor group [52.2% （12 cases） vs.30.6% （15 cases）], but had no significant difference （P=0.08）.The mean HY stage was higher in the HP-infected patient group than in the non-infected group [（2.6±0.7） vs.（2.2±0.9）, P=0.03].The HP infection rate was higher in patients with HY stage ≥2 than with HY stage 〈2 [46.4% （26 cases） vs.6.3% （1 case）,P=0.003].There were no correlations of HP infection with gender, age, age of onset, UPDRS, UPDRS-Ⅲ, PDQ-39, the course of the disease, wearing-off phenomenon, and dyskinesias.Conclusions The PD patients with HP infection are mainly at middle-and late-stage.HP infection may be related with the progress of the disease.It needs further study and validation by expanding the sample to investigate whether HP infection affects the motor complications.