帕金森病异动症发病的相关因素分析

Factors associated with development of dyskinesia in Parkinson's disease

目的探讨帕金森病异动症(LID)发生的相关因素。方法应用统一帕金森病(PD)评分量表(UPDRS)第2、3部分和第4-A部分,Hoehn-Yahr分期评分共随访410例PD患者,将UPDRS量表第IV-A部分32项≥1分的患者纳入LID组,并与非LID组的年龄、性别、发病年龄、主要临床亚型、病程、使用多巴制剂的疗程及当前的治疗情况等因素进行统计分析。结果 410例帕金森病患者中的396例患者坚持规律服药2个月以上,并且其中的105例患者出现异动症,LID组与非LID组在性别、年龄、发病年龄、病程、使用左旋多巴疗程、剂量、Hoehn-Yahr分期及统一帕金森病评分量表第3部分评分之间差异有统计学意义。异动症相关的多因素Logistic回归分析显示,性别、年龄、发病年龄、病程及使用左旋多巴的日剂量是LID发生的独立危险因素。结论女性患者,年龄及发病年龄较轻,病程较长以及使用左旋多巴日剂量较大的帕金森病患者易发生异动症。

Objective To explore the factors related to dyskinesia in Parkinson＇s disease（PD）.Methods The patients＇ score on the motor component and ability of daily living（Part 2 and 3）of the Unified Parkinson＇s Disease Rating Scale（UPDRS）and Hoehn-Yahr stage were recorded.Levodopa-induced dyskinesia（LID）was considered to be present if the patient had a score of 1 or more on item 32 of the UPDRS Part 4.Clinical data including age,gender,age at disease onset,initial clinical manifestation,duration of disease,time when Levodopa therapy was started,and current treatment were analyzed and compared between the two groups.Results Of the 410 cases with PD,396 patients received regular treatment with Levodopa for at least2 months,among which 105 patients developed LID by the end of the study.There were statistically significant differences in gender,age,age at onset of disease,duration of disease,duration and dose of Levodopa treatment,score on UPDRS part 3 and Hoehn-Yahr stage between the LID and non-LID groups.Multivariate logistic regression analysis showed that age,gender,age at onset of PD,duration of disease and dose of Levodopa were the independent risk factors of LID.Conclusions The results showed that the development of LID is more likely in young female patients with early onset of the disease,a longer duration of PD and a higher daily dose of Levodopa.