根除幽门螺杆菌对帕金森病患者的运动功能、认知功能及日常生活活动能力的影响

Effect of Helicobacter pylori eradication on motor function,cognitive function and activities of daily living of Parkinson's disease

目的探讨根除幽门螺杆菌(Hp)对帕金森病(PD)患者的运动功能、认知功能及日常生活活动能力的影响。方法选择2015年1月至2016年8月湛江市第二人民医院神经内科收治的Hp阳性患者88例,采用随机数表法将患者分为观察组和对照组,每组44例。对照组仅给予左旋多巴/苄丝肼片治疗,疗程为3个月。观察组给予左旋多巴/苄丝肼片联合根除Hp治疗,疗程为14 d。根除Hp疗程结束1个月后统计Hp根除成功率。采用帕金森病统一评分量表(UPDRS)、UPDRSⅢ、Hoehn-Yahr(H-Y)分级表、UPDRSⅣ、蒙特利尔认知评估量表、Barthel指数分别评估两组患者的疗效、运动功能、治疗并发症、认知功能和日常生活活动能力。结果 Hp根除率为84.09%。观察组患者的治疗总有效率为86.49%,明显高于对照组的63.64%,差异有统计学意义(P<0.05);治疗后,观察组患者的UPDRSⅢ评分、H-Y分级和UPDRSⅣ评分分别为(22.36±8.67)分、(2.30±0.54)级和(2.62±0.61)分,均明显低于对照组的(26.55±9.16)分、(2.59±0.49)级和(3.19±0.63)分,差异均有统计学意义(P<0.05);治疗1年后,观察组患者的视空间与执行功能、命名、注意力、语言、抽象能力和延迟回忆的评分分别为(4.08±0.26)分、(2.55±0.17)分、(4.12±0.72)分、(2.58±0.66)分、(1.68±0.15)分和(3.49±1.14)分,均明显高于对照组的(3.91±0.32)分、(2.36±0.15)分、(3.74±0.68)分、(2.22±0.75)分、(1.60±0.13)分和(2.95±1.06)分,差异均有统计学意义(P<0.05)。观察组患者的临床满意率为78.38%,明显高于对照组的54.55%,差异有统计学意义(P<0.05)。结论根除Hp可提高帕金森病的疗效、运动功能、认知功能和日常生活活动能力,同时可减少治疗并发症。

Objective To investigate the effects of Helicobacter pylori eradication on motor function, cognitivefunction and activities of daily living of Parkinson＇s disease （PD）. Methods A total of eighty-eight patients with PD,who admitted to Department of Neurology of the Second People＇s Hospital of Zhanjiang from January 2015 to August2016, were divided into the control group and the observation group, with 44 cases in each group. The control group wastreated with Levodopa/Benserazide tablets for 3 months; the observation group was treated with Levodopa/Benserazidetablets plus Hp eradication for 14 d. After 1 month of Hp eradication, the rate of Hp eradication was observed. The cura-tive effect, motor function, complications of treatment, cognitive function and activities of daily living were evaluated byParkinson＇s Disease Rating Scale （UPDRS）, UPDRSⅢ, Hoehn-Yahr （H-Y） scale, UPDRS Ⅳ, Montreal Cognitive As-sessment, Barthel index respectively. Results The eradication rate of Hp was 84.09%. The total effective rate of the ob-servation group was 86.49%, which was significantly higher than 63.64% of the control group （P〈0.05）. After the treat-ment, the UPDRSⅢ, H-Y and UPDRSⅣ scores of the observation group were （22.36±8.67）, （2.30±0.54）, （2.62±0.61）,respectively, which were significantly lower than corresponding （26.55±9.16）, （2.59±0.49）, （3.19±0.63） in the controlgroup （P〈0.05）. After 1 year of treatment, The scores of visual space and executive function, naming, attention, lan-guage, abstract ability and delayed recall of the observation group were （4.08±0.26）, （2.55±0.17）, （4.12±0.72）, （2.58±0.66）, （1.68±0.15）, （3.49±1.14）, respectively, which were significantly higher than corresponding （3.91±0.32）, （2.36±0.15）, （3.74±0.68）, （2.22±0.75）, （1.60±0.13）, （2.95±1.06） in the control group （P〈0.05）. The clinical satisfaction rate was78.38% in the observation group versus 54.55% in the control group （P〈0.05）. Conclusion Hp eradication can im-prove the curative effect, motor function, cognitive function and activities of daily living, and reduce the complicationsof treatment.