帕金森病伴发视幻觉患者的临床特征及相关因素分析

Analysis of Clinical Features and Related Factors in Parkinson's Disease with Visual Hallucinations

目的通过横断面研究评价帕金森病(PD)伴发视幻觉的发生率及临床特征,探讨相关影响因素。方法纳入564例PD患者,依据非运动症状筛查量表筛查PD伴发或不伴发视幻觉,分为:伴发视幻觉(PD-VH)组和不伴发视幻觉(PD-NVH)组。分析其临床特征及相关因素。结果PD-VH组87/564例(15.4%),其中男性56/87例(64.4%),女性31/87例(35.6%);PD-NVH组477/564例(84.6%),其中男性240/477例(50.3%),女性237/477例(49.7%)。PD-VH组与PD-NVH组比较,男性多见。年龄大,病程长,H-Y分期和UPDRS评分高,姿势不稳/步态障碍型多见,且易伴发其他非运动症状(均P<0.05)。相关因素分析发现:性别、病程以及UPDRS-Ⅰ、汉密尔顿抑郁量表、Epworth嗜睡量表评分与PD伴发视幻觉相关;此外复视也是视幻觉的相关因素。结论视幻觉是PD患者中常见的一种非运动症状。

Aim To evaluate the prevalence and clinical features of visual hallucinations in Parkinson's disease(PD)and explore the related risk factors.Methods A total of 564 patients diagnosed with Parkinson's disease(PD)were selected.The visual hallucinations were screened by the nonmotor symptoms questionnaire(NMSQ),and their clinical features and related factors were analyzed.Results(1)The incidence of visual hallucinations in PD was 15.4%,which was more common in males.(2)The age,disease duration,Hoehn and Yahr(H-Y)stage,UPDRS scores and percentage of postural instability/gait difficulty phenotypes and patients with other non-motor symptoms in PD with visual hallucinations were significantly greater than in patients without visual hallucinations(P<0.05).(3)Analysis of related risk factors found that gender,course of disease and scores of UPDRS-Ⅰ,Hamilton Depression Scale(HAMD-24)and Epworth Sleeping Scale(ESS)were correlated with visual hallucinations in PD.Diplopia was also related to visual hallucinations.Conclusion Visual hallucination is a common nonmotor symptom in PD patients.