帕金森病患者运动障碍和症状波动的影响因素

Factors of dyskinesias and motor fluctuations in Parkinson's disease

目的 观察帕金森病患者运动障碍和症状波动发生情况 ,探讨两者发生的影响因素。方法 对确诊的帕金森病患者进行随访 ,记录患者详细资料并进行UPDRS、H Y分级、Schwab和英格兰日常生活量表评分 ,观察有无运动障碍和症状波动发生。对所得资料进行统计分析。结果 6 3例帕金森病患者均接受左旋多巴治疗 ,观察发现 11例 (17 5 % )出现运动障碍 ,其中 10例表现为肌张力障碍 ;36例 (5 7 1% )出现症状波动 ,其中 2 8例表现为剂末现象。左旋多巴平均日剂量 (r =9 76 8,P =0 0 0 1)、UPDRS off评分 (r =0 0 76 ,P =0 0 0 8)与运动障碍呈正相关 ,左旋多巴治疗时间与症状波动呈正相关 (r=0 738,P =0 0 0 2 ) ,控释剂的使用与其呈负相关 (r =- 3 378,P =0 0 15 )。结论本组患者运动障碍的发生率较低 ,而症状波动的发生率与国外报道相近 ,左旋多巴平均日剂量和病情严重程度是运动障碍的主要影响因素 ,其治疗时间是症状波动的影响因素。运动综合征主要表现为剂末现象和肌张力障碍。

Objective To observe the dyskinesias and motor fluctuation in patients with Parkin-son’s disease, and investigate their influential factors. Methods The detail information of dyskinesias and motor fluctuation of 63 patients with Parkinson’s disease were recorded and followed up when the of L-Dopa therapy was carried out, and all patients were assessed by using UPDRS at “on” and “off” stage, Hoehn and Yahr scale, Schwab and England living scale.The data were calculated with SPSS 10.0 statistic software. Results All patients received alone or combined L-Dopa therapy.Among the 63 patients, 11 (17.5%) were experienced dyskinesias, in which 10 show dystonia; and 36 were (57.1%) experienced motor fluctuation, in which 28 developed wearing-off.The mean daily dose of L-dopa and score of UPDRS in “off” stage were positively correlated with dyskinesias.The duration of therapy with L-dopa was positively correlated with motor fluctuation.The controlled release cabidopa/levodopa was in negative correlation. Conclusions The rate of motor fluctuation was approximately equal to the results reported in other countries.The dyskinesias was lower in occurrence and the mean daily dose of L-dopa and the disease severity should be the main influencing factors to the dyskinesias.The duration of therapy with L-dopa should be influencing factor to motor fluctuation.The main subtype of motor complications should be dystonia and wearing-off.