帕金森病患者非运动症状的影响因素分析以及与运动症状的关系

The effects of basic characteristics of patients on non-motor symptoms and the relationship between motor symptoms and non-motor symptoms in patients with Parkinson＇s disease

目的研究性别、发病年龄、受教育程度、不对称性是否对帕金森病非运动症状构成影响，分析帕金森病非运动症状与运动症状的关系。方法连续选取门诊确诊为原发性帕金森病的157例患者，详细记录其起病年龄等临床资料，评定非运动症状筛查量表、统一帕金森病评分量表、简易智能精神状态检查量表、汉密尔顿抑郁量表等。结果睡眠紊乱受性别影响（P〈0．05），女性患者睡眠障碍较突出；认知障碍受发病年龄和受教育时间影响i疼痛和感觉障碍受发病年龄影响（P〈0．05），发病年龄越大，疼痛和感觉障碍越明显。不对称性（左侧优势型、右侧优势型、对称型）对非运动症状的影响差异无统计学意义（均P〉0．05）。姿势步态异常得分越高，简易智能精神状态检查量表得分越低（β=-1．837，P=0．004），震颤得分越高，汉密尔顿抑郁量表得分越高（β=3．460，P=0．001），强直少动得分越高，自主神经功能障碍得分越高（β=0．104，P=0．006）。结论帕金森病非运动症状受到患者年龄、性别和文化水平影响。不对称性不影响帕金森病非运动症状。非运动症状与运动症状相关，临床工作中姿势步态异常显著患者应重点关注其认知功能，震颤显著患者应重点关注其情绪变化，遇到强直少动为著的患者，应警惕自主神经症状发生。

Objective To investigate whether sex, age-of-onset, education and asymmetry affect non motor symptoms （NMS）in Parkinson disease, and to analyze the relationship between motor symptoms and NMS in Parkinson＇ s disease. Methods The detailed clinical information of 157 patients with idiopathic Parkinson＇s disease（PD）was recorded and followed up. The data was calculated with SPSS statistic software. Sex had an impact on sleeping disorder（P〈 0.05）. Sleep disorder in female was more prominent. Cognitive disorder was affected by age-of-onset and education duration. The pain and sensory disorder were affected by age o6onset（P〈0.05）. Differences in the effects of asymmetry on NMS were not statistically significant（P〈0.05）. The higher the scores of postural instability and gait difficulty（PIGD）were, the lower the Mini-Mental State Examination （MMSE） score was（β=- 1.837, P = 0.004）.The higher the tremor score was, the higher the Hamilton Depression Scale（HAMD） score was（β= 3. 460, P = 0. 001 ）. The higher the rigidity akinesia score was,the higher the autonomic dysfunction score was（β=0. 104,P=0. 006）. Conclusions The non motor symptoms of Parkinson＇s disease are affected by the age, sex and cultural level. Symmetry- or-not does not affect Parkinson＇s disease. Non motor symptoms and motor symptoms are closely linked. The encountered posture and gait abnormalities of patients should trigger physician alerts to focus on patients＇ cognitive function. The encountered tremor of patients should trigger physician alerts to focus on their emotional changes. Facing to the patient with rigidity and less moving,physician should alert to the occurrence of autonomic symptoms.