文章摘要
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,2019,(12):1764~1768
不同运动表型帕金森病患者非运动症状的相关因素研究
Study on related factors of non⁃motor symptoms in patients with different motor phenotypes of Parkinson’s disease
投稿时间:2018-09-23  
DOI:10.7655/NYDXBNS20191213
中文关键词: 帕金森病  运动表型  非运动症状
英文关键词: Parkinson’s disease  motor phenotype  non⁃motor symptoms
基金项目: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)
作者单位
曹雯燕 苏北人民医院神经电生理室江苏 扬州 225000 
刘晓光 苏北人民医院神经外科江苏 扬州 225000 
马灿灿 苏北人民医院神经内科江苏 扬州 225000 
陈应柱 苏北人民医院神经内科江苏 扬州 225000 
任晓梅 苏北人民医院神经内科江苏 扬州 225000 
张洪英 苏北人民医院医学影像科江苏 扬州 225000 
徐 耀 苏北人民医院神经内科江苏 扬州 225000 
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中文摘要:
      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。
英文摘要:
      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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