不同运动表型帕金森病患者非运动症状的相关因素研究
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扬州市科技局社会发展面上项目(YZ2016077);国家自然科学基金面上项目(81471642);江苏省“六大人才”高峰培养资助(WSW?246)


Study on related factors of non⁃motor symptoms in patients with different motor phenotypes of Parkinson’s disease
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    摘要:

    目的:研究不同运动表型帕金森病(parkinson’s disease,PD)患者非运动症状发生率及严重程度的差异,并进一步研究差异的影响因素。方法:对2016年10月—2018年4月就诊于苏北人民医院门诊及病房住院的诊断为原发性PD 91例进行各项非运动量表及运动量表的评定,包括非运动症状问卷(NMSQ)、自主神经症状量表(SCOPA-AUT)、汉密尔顿抑郁量表(HDRS)、匹茨堡睡眠质量指数(PSQI)、蒙特利尔认知评估(MoCA)和简易精神状态量表(MMSE),通过帕金森病评分量表(UPDRS)Ⅱ、Ⅲ部分的评分分为震颤型(TD)22例,姿势步态异常型(PIGD)53例,不确定分型16例,分析比较TD组及PIGD组患者各项非运动量表得分的差异及该差异产生的影响因素。结果:两组患者年龄、性别、病程、MMSE、HDRS、FSS、 PSQI评分无统计学差异(P > 0.05),教育水平(P=0.031)、平均发病年龄(P=0.038)、H-Y分级(P=0.011)、UPDRS-Ⅲ总分(P=0.011)、SCOPA-AUT评分(P=0.019)、NMSQ评分(P=0.009)有统计学差异,进一步分析MoCA评分、NMSQ评分、SCOPA-AUT评分的影响因素,发现教育水平及UPDRS-Ⅲ总分是MoCA评分的影响因素,P值分别为<0.001、0.003;HDRS得分及H-Y分级是SCOPA-AUT评分的影响因素,P值分别为<0.001、0.044;年龄、HDRS得分、FSS得分及UPDRS-Ⅲ总分是NMSQ得分的影响因素,P值分别为0.031、<0.001、0.008、0.005。结论:本研究分析发现年龄、抑郁情绪、疲劳障碍及运动症状的严重程度是非运动症状发生的影响因素,抑郁情绪及H-Y分级是自主神经症状发生的影响因素,教育水平及运动症状的严重程度是认知损害的影响因素。

    Abstract:

    Objective:This study aims to compare differences in the incidence and severity of non-motor symptoms in Parkison’s disease(PD) patients with different motor phenotypes,and to further study the influencing factors. Methods:From October 2016 to April 2018,91 patients were diagnosed as primary PD in Jiangsu Subei People’s Hospital were included in this research. PD patients were administrated with non-motor scales and motor scales,including non- Motor Symptoms Questionnaire(NMSQ),Autonomic Symptom Scale(SCOPA-AUT),Hamilton Depression Rating Scale(HDRS),Pittsburgh Sleep Quality Index(PSQI),MoCA,and Mini-Mental State Scale(MMSE),the unified Parkinson’s Disease Rating Scale(UPDRS)Ⅱ and Ⅲ,according to UPDRS Ⅱ and Ⅲ score,all patient were divided in to 12 cases of tremor type(TD),53 cases of postural instability and gait difficulty(PIGD)and 16 cases uncertain type,the differences of scores in the non-motor scales between the TD group and PIGD group were compared,and the influencing factors of the differences were further analyzed. Results:There were no significant differences in age,gender,duration of disease,MMSE,HDRS,FSS,and PSQI scores between the two groups(P > 0.05),education level(P=0.031),age of onset(P=0.038),and H-Y grade(P=0.011),UPDRS-Ⅲ total score(P=0.011),SCOPA-AUT score(P=0.019),NMSQ score(P=0.009)were statistically different. And the influencing factors of the MoCA score,NMSQ score and SCOPA-AUT score was further analyzed,the education level and UPDRS-Ⅲ total score were the influencing factors of MoCA score,P value was <0.001,0.003,respectively;HDRS score and H-Y scale are the influencing factors of SCOPA-AUT score,P value was < 0.001 and 0.044;Age,HDRS score,FSS score and UPDRS-Ⅲ total score are the influencing factors of NMSQ score,P value was 0.031,<0.001,0.008,0.005,respectively. Conclusion:The age,severity of depression,fatigue and motor symptoms are influencing factors of non-motor symptoms,the occurrence of depression and H-Y scale are the influencing factors of the occurrence of autonomic nervous symptoms,and the level of education and the severity of motor symptoms are the influencing factors of the cognitive impairment.

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曹雯燕,刘晓光,马灿灿,陈应柱,任晓梅,张洪英,徐 耀.不同运动表型帕金森病患者非运动症状的相关因素研究[J].南京医科大学学报(自然科学版),2019,(12):1764-1768

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  • 收稿日期:2018-09-23
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  • 在线发布日期: 2020-01-09
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