女性帕金森病患者经期影响的相关因素分析

Related factors analysis of the influence of menstruation on female patients with Parkinson's disease

目的调查育龄期女性帕金森病(PD)患者受经期影响的患病率及临床特征。方法采用调查问卷、病例对照研究,连续选取自2015年6月~2016年1月我院门诊及天坛医院PD专病门诊发病年龄在50岁以下女性PD患者,记录受经期影响的病例数,分为经期相关组和与经期无关组,分析两组临床的异质性。同时收集两组发病年龄、文化程度、初始症状、病程、有无毒物接触史、家族史、统一PD评定量表第Ⅲ部分(UPDRS-Ⅲ)评分、改良Hoehn-Yahr(H-Y)分级、贝克焦虑量表(BAI)等资料。结果共收集175例女性PD患者,经期受影响者42例,患病率为24%;将经期相关组与经期无关组分别在非经期及经期期间进行比较,非经期期间,两组在发病年龄、BAI方面差异有统计学意义(均P<0.05),而在病程、文化程度、有无毒物接触史、家族史、UPDRS-Ⅲ、改良H-Y分级等方面则差异无统计学意义(均P>0.05),但在经期期间,两组在发病年龄、UPDRS-Ⅲ、改良H-Y分级、BAI等方面均存在明显统计学意义(均P<0.000)。结论女性育龄期PD患者易受经期影响,临床症状恶化,表现为运动症状加重,更易合并焦虑,提示该类患者日常生活能力及生活质量更差,应提醒临床医生的识别。

Objective To investigate the prevalence and clinical characteristics of female patients of＂ childbearing age with Parkinson＇s disease during the menstrual period. Methods A case control study was con- ducted using the questionnaire. Female patients with Parkinson＇s disease under the age of 50 were selected from outpatient clinics of Aerospace Central Hospital and specialized PD clinic of Beijing Tiantan Hospital between lune 2015 to January 2016. These cases were divided into menstrual related group and menstrual unrelated group according to the influence of menstruation. Clinical heterogeneities were analyzed between the two groups. The clinical data of age of onset, educational level, initial symptoms, duration of disease, history of exposure to poison, family history, Unified Parkinson Disease Rating Scale llI（ UPDRS- Ill ） scores, modified Hoehn-Yahr classification and Beck Anxiety Inventory were collected. Results One hundred and seventy-five cases were collected, including of 42 cases in menstrual related group, and the prevalence was 24%. The menstrual related group and menstrual unrelated group were compared during the non menstrual period and menstrual period separatedly. There were statistically significant differences in age of onset and Beck Anxiety Inventory （ all P 〈 0. 05 ） but no significant differences in duration of disease, educational level, history of exposure to poison, family history, UPDRS-Ⅲ scores and modified Hoehn-Yahr classification （ all P 〉 0. 05 ） between the two groups during the non menstrual period. There were statistically significant differences in age of onset, UPDRS-m scores, modified Hoehn-Yahr classification and Beck Anxiety Inventory （ all P 〈 0.000 ） during the menstrual period. Conclusions Female PD patients of childbearing age are ,,ore influenced by menstruation. The deterioration of clinical symptoms manifested as aggravated motor symptoms and these patients are more likely to coexist with anxiety, indicating of the poorer daily life ability and quality. The awareness of the conclusion should be raised.