影响帕金森病运动亚型的相关因素分析

Analysis of related factors affecting motor subtypes of Parkinson’s disease

目的研究帕金森病步态和姿势异常亚型(Postural instability gait disorder,PIGD)与震颤亚型(Tremor dominant,TD)的临床表现差异以及影响帕金森病亚型的相关因素。方法收集2019年1月至2020年1月就诊于我院帕金森病专科门诊的69例帕金森病患者,分为PIGD组和TD组进行临床资料采集以及量表评估,量表包括Hoehn-Yahr量表(H-Y)、国际运动障碍学会统一帕金森病评定量表(MDS-UPDRS)、非运动症状评价量表(NMSS)、帕金森病睡眠量表(PDSS)、简明智力状态检查(MMSE)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、帕金森病生活质量评价量表(PDQ-39)。将收集的数据进行统计学分析。结果两组患者在发病年龄、病程、服用左旋多巴等效剂量、HAMA、HAMD、MMSE、PDSS、NMSS、PDQ-39评分的方面差异无统计学意义。在发病年龄、受教育程度、是否患有共病、UPDRS评分、H-Y分级、僵硬、运动迟缓、震颤、姿势和步态异常的方面差异有统计学意义。进行下一步相关性分析发现患者发病年龄、共病严重程度、H-Y分级、UPDRS评分、运动症状与PD亚型有相关性。结论帕金森病患者的发病年龄、共病严重程度、疾病严重程度、运动症状是影响PIGD亚型的相关因素。

Objective To investigate the differences between the subtypes of postural instability gait difficulty(PIGD)subtypes.in Parkinson’s disease and the subtypes of tremor and the related factors affecting the phenotypes of Parkinson’s disease.Methods Collect hospital between January 2019 and January 2020 in our hospital nursing of 69 patients with Parkinson’s disease,Parkinson’s disease is divided into PIGD and TD groups to evaluate clinical data acquisition and scale,scale including Hoehn-Yahr scale,MDS-UPDRS scale,non-motor symptoms scale(NMSS),Parkinson’s disease sleep scale(PDSS),Mini-mental State Examination(MMSE)and Hamilton Depression Scale(HAMD),Hamilton anxiety scale(HAMA),Parkinson’s life quality evaluation scale(PDQ-39).The collected data were statistically analyzed.Results There was no statistically significant difference between the two groups in age of onset,course of disease,equivalent dose of levodopa,HAMA,HAMD,MMSE,PDSS,NMSS and PDQ-39 scores.Differences were statistically significant in age of onset,education,medical comorbidities,UPDRS score,H-Y rating,stiffness,bradykinesia,tremor,and gait abnormalities.The next step of correlation analysis found that patients’age of onset,comorbidity severity,H-Y classification,UPDRS score,and exercise symptoms were correlated with PD subtypes.Conclusion The age of onset,the severity of medical comorbidities,disease severity,and motor subtypes of PD patients were related factors affecting the PIGD subtypes.