原发性帕金森病患者非运动症状的临床特点

Clinical characteristics of non-motor symptoms in patients with primary Parkinson’s disease

目的探讨帕金森病患者非运动症状的临床特点。方法连续纳入2020-01-2021-12在常德市第一人民医院神经内科住院部和门诊部的原发性帕金森患者71例。收集患者的一般资料、非运动症状评价量表(non-motor symptom evaluation scale,NMSS)、统一帕金森病评定量表(unified Parkinson’s disease rating scale,UPDRS)等指标。根据患者H-Y分期,分为1~2期组(n=40)和2.5~4期组(n=31),比较2组NMSS总分、心血管系统、睡眠与疲劳等指标。采用线性回归对原发性帕金森病患者发生非运动症状的相关因素进行分析。结果2.5~4期组患者NMSS总分高于1~2期组[分别为(37.55±29.00)分、(25.05±22.89)分,P<0.05],其中2.5~4期组心血管系统、睡眠与疲劳、胃肠道系统和泌尿系统4项得分分别为(37.54±29.00)分、(1.42±1.96)分、(5.90±5.49)分、(6.74±7.94)分,1~2期组分别为(25.05±22.89)分、(0.44±1.02)分、(3.18±4.73)分、(3.18±5.20)分,2组比较,2.5~4期均高于1~2期组(P<0.05);NMSS总分与UPDRS评分呈正相关(r=0.6,P<0.01)。多元线性回归分析结果显示,调整不同混杂因素后,UPDRS评分是NMSS总分的独立危险因素(B=0.515,95%CI=0.285~0.874,P<0.01)。结论帕金森患者存在多种形式非运动症状,疾病分期越重,非运动症状越重,同时NMSS总分与UPDRS评分呈正相关。

Objective To explore the clinical characteristics of non-motor symptoms in patients with Par⁃kinson’s disease.Methods Seventy-one patients with primary Parkinson’s disease in the neurology inpatient and outpatient departments of the First People’s Hospital of Changde from January 2020 to December 2021 were consecutively included.General data,non-motor symptom evaluation scale(NMSS),unified Parkinson’s disease rating scale(UPDRS)and other indicators of patients were collected.According to H-Y stage,the patients were divided into 1-2 stage group(n=40)and 2.5-4 stage group(n=31),and the NMSS total score,cardiovascular system,sleep and fatigue were compared between the two groups.Linear regression was used to analyze the related factors of non-motor symptoms in patients with primary Parkinson’s disease.Results The total score of NMSS in the 2.5-4 stage group was higher than that in the 1-2 stage group(37.55±29.00,25.05±22.89,respectively,P<0.05),in which the four scores of cardiovascular system,sleep and fatigue,gastrointestinal system and urinary system were 37.54±29.00,1.42±1.96,5.90±5.49,and 6.74±7.94 in the 2.5-4 stage group,and 25.05±22.89,0.44±1.02,3.18±4.73,and 3.18±5.20 in the 1-2 stage group.Compared with the two groups,the 2.5-4 stage was higher than the 1-2 stage group(P<0.05).NMSS total score was positively correlated with UPDRS total score(r=0.6,P<0.01).The re⁃sults of multiple linear regression analysis showed that UPDRS score was an independent risk factor for total NMSS score after adjusting for different confounders(B=0.515,95%CI=0.285-0.874,P<0.01).Conclusion Patients with Parkinson’s disease have many forms of non-motor symptoms,the more severe the disease stage,the more severe the non-motor symptoms.At the same time,the total NMSS score was positively correlated with the UPDRS score.