浙南地区不同运动亚型帕金森病患者非运动症状的比较分析

Comparison of non-motor symptoms in patients with different subtypes of Parkinson's disease

目的比较浙南地区不同运动亚型帕金森病(PD)患者非运动症状的差异。方法选取2018年1月至2020年4月在温州医科大学附属第二医院神经内科门诊和住院的PD患者88例,分为姿势异常步态障碍(PIGD)为主型、震颤(TD)为主型和中间型,比较不同运动亚型PD患者性别、年龄、发病年龄、病程、左旋多巴等效剂量(LEDD)、统一PD评定量表(UPDRS)评分、UPDRS第三部分(UPDRS-Ⅲ)评分、Hoehn-Yahr(H-Y)分期、PD非运动症状评定量表(NMSS)评分。结果不同运动亚型PD患者H-Y分期和NMSS评分比较差异均有统计学意义(均P<0.05)。PIGD型患者在心血管症状、睡眠/疲劳、情绪/认知、感知障碍、胃肠道症状、泌尿系统症状、混合症状方面较TD型患者更严重(均P<0.05)。结论不同运动亚型PD患者在非运动症状方面存在着较大差异,PIGD型患者在非运动症状方面较TD型患者更加严重,应在临床工作中引起重视。

Objective To compare the non-motor symptoms in Parkinson's disease(PD)patients with different subtypes.Methods Eighty-eight patients with Parkinson's disease were enrolled from January 2018 to April 2020 in the second affiliated hospital of Wenzhou medical university,including 41 cases of postural instability and gait disorder subtype(PIGD),30 cases of tremor dominant subtype(TD)and 17 cases of intermediate subtype.The gender composition,age,age of onset,disease duration,levodopa equivalent daily dose(LEDD),unified PD rating scale(UPDRS)score,UPDRS-Ⅲscore,Hoehn-Yahr(H-Y)stage,non-motor symptom assessment scale(NMSS)were compared among three groups.Results H-Y stage and NMSS scores among the three groups were significantly different.Patients with PIGD subtype had more severe cardiovascular,sleep/fatigue,mood/cognition,perceptual problems,gastrointestinal tract,urinary,and miscellaneous symptoms than patients with TD subtype(all P<0.05).Conclusion The non-motor symptoms of PD patients with different subtypes are different.PIGD patients have more severe non-motor symptoms than TD patients.