帕金森病病人体位性低血压的发生率及其相关因素分析

Incidence of orthostatic hypotension in patients with Parkinson’s disease and its related factors

目的调查帕金森病(PD)病人体位性低血压(orthostatic hypotension,OH)的发生率,并分析其相关因素。方法选取PD病人130例,所有病人入院后第2天进行卧立位血压的测定和各项精神量表的评估,其中合并体位性低血压(PD-OH)组55例,不合并体位性低血压(PD-NOH)组75例。对2组间临床资料进行比较分析。结果PD-OH组病人的年龄、PD起病年龄和左旋多巴的等效剂量(levodopa equivalent dose,LED)明显高于PD-NOH组,差异具有统计学意义(P<0.05)。Spearman相关性分析结果显示,收缩压差值和年龄、PD起病年龄呈正相关(r=0.279,0.281,均P<0.001);舒张压差值和年龄呈正相关(r=0.177,P<0.001),和性别呈负相关(r=-0.203,P<0.001);2组病人血压与病程、HY分期、LED、统一帕金森病评定量表(UPDRS)、帕金森病非运动症状问卷(NMSQ)、汉密尔顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、疲劳严重程度量表(FSS)、蒙特利尔认知评估(MoCA)、简易精神状态检查量表(MMSE)和帕金森病问卷-39(PDQ39)评分均无明显相关性。结论PD病人OH的发生率高,且随着PD病人的年龄和起病年龄的增加,OH的严重程度增加。

Objective To investigate the incidence of orthostatic hypotension(OH)in the patients with Parkinson's disease(PD),and to analyze the related factors.Methods A total of 130 cases of PD patients were selected in this study.Blood pressure and psychiatric assessment scales were measured and analyzed.Results In all patients,55 cases(43.3%)presented with OH(PD-OH)and 75 cases without OH(PD-NOH).The age,onset age and levodopa equivalent dose(LED)in PD-OH group were significantly higher than those in PD-NOH group(P<0.05).Spearman correlation analysis showed that systolic blood pressure difference was positively correlated to age and onset age(r=0.279,0.281,all P<0.001),and diastolic blood pressure difference was positively correlated to age(r=0.177,P<0.001),and negatively correlated with gender(r=-0.203,P<0.001).The blood pressure showed no significant correlation with duration,HY stage,LED,Unified Parkinson's disease rating scale(UPDRS),non-motor symptoms questionnaire(NMSQ),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),fatigue severity scale(FSS),Montreal cognitive assessment(MoCA),mini-mental state examination(MMSE)and 39-item Parkinson's disease questionnaire(PDQ39).Conclusions The incidence of OH is high in PD patients,and the severity of OH increases with the age and the age of onset in the PD patients.