帕金森病患者的同胞和配偶非运动症状调查

Investigation of the incidences of non-motor symptoms in siblings and spouses of patients with Parkinson＇s disease

目的 非运动症状是帕金森病的重要前驱症状,帕金森病患者的同胞及配偶无典型运动症状,我们欲探究他们是否有帕金森病前驱症状.方法 连续收集2015年1月至2017年8月扬州大学附属医院神经内科门诊及住院的帕金森病患者98例、他们的同胞256名、87名帕金森病患者的配偶以及对照250名.采用各种量表对所有入组人员进行评估,包括抑郁情绪、焦虑情绪、认知功能、睡眠状况、便秘、日间嗜睡、快速眼球运动期睡眠行为障碍（RBD）、不宁腿综合征（RLS）、主观嗅觉等.结果 与对照组相比,患者同胞组有更多的焦虑（OR=3.06,95％CI1.86～5.05,P＜0.01）、抑郁（OR=2.16,95％CI 1.16～4.04,P=0.01）、RBD（OR=3.83,95％CI1.79～8.19,P＜0.01）和主观嗅觉障碍（OR=4.48,95％CI 2.02～9.90,P＜0.01）,便秘、认知障碍、睡眠障碍、日间嗜睡、RLS发生率等差异无统计学意义.配偶组中轻度抑郁（OR=2.58,95％CI 1.07～6.20,P=0.03）较明显,其余各项非运动症状与对照组相比均差异无统计学意义.结论 帕金森病患者的同胞更容易有帕金森病前驱症状,推测可能与共同的基因背景或者早期生存环境相关.帕金森病患者的配偶无明显非运动症状,可以推断帕金森病的发病与成人后家庭生活环境无关.

Objective Non-motor symptoms are important prodromal characteristics of Parkinson＇s disease （PD）.The siblings and the spouses of PD patients do not have classic motor symptoms.This study aimed to investigate if they have PD prodromal symptoms.Methods A total of 98 PD patients from the Affiliated Hospital of Yangzhou University were recruited between January 2015 and August 2017;256 siblings of these patients were included in a siblings group,87 spouses of PD patients were included in a spouses group and 250 healthy individuals were included in a control group.Various scales were used to assess non-motor symptoms,including depression,anxiety,cognitive function,sleep status,constipation,daytime sleepiness,subjective olfactory disorder,rapid-eye-movement sleep behavior disorder （RBD）,and restless legs syndrome （RLS）.Results The incidence of anxiety （OR=3.06,95%CI 1.86-5.05,P〈0.01）,depression （OR=2.16,95%CI 1.16-4.04,P=0.01）,RBD （OR=3.83,95%CI 1.79-8.19,P〈0.01） and subjective olfactory disorder （OR=4.48,95%CI 2.02-9.90,P〈0.01） was higher in the siblings group than the control group.There were not statistically significant differences in constipation,cognitive impairment,sleep disorder,daytime sleepiness,and RLS between the two groups.There were not statistically significant differences in non-motor symptoms between the spouses group and the control group,except that the mild depression （OR=2.58,95%CI 1.07-6.20,P =0.03） in the spouses group was more obvious.Conclusions The siblings of PD patients are more likely to have PD prodromal symptoms compared with those without PD family history,perhaps because PD patients and their siblings have common pathogenic genetic factors and early living environment for neurodegeneration.There are no obvious non-motor symptoms in the spouses of PD patients.It can be concluded that the onset of PD is not related to the family life environment in adulthood.