便秘对帕金森病冻结步态的影响

Effect of constipation on the freezing of gait in Parkinson’s disease

目的探讨便秘是否为帕金森病(PD)冻结步态(FOG)的独立危险因素,为PD-FOG的治疗和早期预防提供依据。方法收集2015-05-26—2022-01-08在首都医科大学宣武医院神经内科住院的1135例PD患者,依据有无FOG表现和UPDRS-Ⅲ评分将患者分为FOG组和非FOG组,收集2组患者临床资料、Hoehn-Yahr分级、UPDRS-Ⅲ评分、MMSE评分、HAMA和HAMD评分,检测外周血中补体和免疫球蛋白,分析便秘与PD-FOG的关系,以及便秘影响PD-FOG发生的机制。结果PD-FOG和便秘的发生率分别为23.96%和51.36%,利用非条件Logistic回归模型分析发现年龄大、长病程以及便秘均是PD-FOG的危险因素,便秘是PD-FOG的独立危险因素,可增加1.77倍的风险;伴便秘PD-FOG患者外周血中补体C3显著升高。结论便秘可增加1.77倍PD-FOG发生的风险,外周血补体C3可能参与这一病理过程。

Objective To investigate the effect of constipation on the freezing of gait(FOG)in Parkinson’s disease(PD)and provide the evidence for the management of PD-FOG.Methods We recruited 1135 cases which were diagnosed as PD in the Neurological Department of Xuanwu Hospital from May 26,2015 to January 8,2022.All cases were stratified into two groups according the manifestation of FOG and UPDRS-Ⅲ.All clinical materials were collected which included Hoehn-Yahr stages,UPDRS-Ⅲ,MMSE,HAMA and HAMD assessment.Serum complements and immunoglobulins were detected by ELISIA.The association between constipation and PD-FOG were analyzed.Results The ratios of PD-FOG and constipation were 23.96%and 51.36%,respectively.Longer duration,older age and constipation were independent risk factors for PD-FOG after adjusting age and sex by Logistic regression.Constipation could increase 1.77-fold risk for PD-FOG.The serum complement C3 was higher in constipation group than non-constipation group in PD patients.Conclusion Constipation could increase 1.77-fold risk for PD-FOG,and serum C3 may be involved in the process.