帕金森病患者运动并发症的调查分析  

Study on motor complications in patients with Parkinson＇ s disease

作　　者：周明珠[1] 刘振国[1] 干静[1] 陆丽霞[1] 吴佳英[1] 陈伟[1] 

机构地区：[1]上海交通大学医学院附属新华医院神经科,200092

出　　处：《中华神经科杂志》2008年第11期744-747,共4页Chinese Journal of Neurology

基　　金：国家教育部留学回国人员基金资助项目（2006-331）;上海市教委发展基金资助项目（06BZ048）;上海市浦江人才计划资助项目;上海市科委上海-飞利浦研究与发展基金合作基金项目（07SP07005）

摘　　要：目的调查帕金森病（PD）患者中异动症及症状波动的发生率、分布情况以及影响因素。方法详细记录患者资料，并进行统一帕金森病评分量表（UPDRS）、Hoehn＆Yahn（H—Y）分级评分。根据UPDRS1V记录患者有无异动症及症状波动。结果122例患者接受左旋多巴治疗，疗程至少6个月。其中15例（12．3％）合并异动症，41例（33．6％）合并症状波动。异动症的独立影响因素为：发病年龄（OR=0．907，P〈0．01）和左旋多巴总量（95％ CI 1．000～1．004，OR=1．002，P〈0．05）；症状波动的独立影响因素为：发病年龄（OR=0．922，P〈0．05），接受左旋多巴治疗的时间（OR=1．234，P〈0．05），左旋多巴总量（95％ CI 1．002—1．008，OR=1．005，P〈0．01）和H—Y分级（OR=1．869，P〈0．05）。结论本组患者异动症及症状波动的发生率均低于欧洲调查结果，每日左旋多巴总量是异动症及症状波动的独立影响因素。添加其他药物辅助治疗而减少左旋多巴用量，可以减少运动并发症的发生。Objective To survey the prevalence and distribution of dyskinesia and motor fluctuations, and to investigate the factors related to the dyskinesia and motor fluctuations. Methods The detailed information were recorded, patients were rated by Unified Parkinson＇s disease rating scalel （UPDRS） and Hoehn-Yahn stage. The occurrence of dyskinesia and motor fluctuations were recorded according to UPDRS IV. Results One hundred and twenty-two patients receiving levodopa treatment for at lease 6 months were involved. Fifteen （ 12.3% ） were experiencing dyskinesia and 41 （ 33.6% ） motor fluctuations. The age of onset（OR =0. 907,P 〈0. 01 ） and daily levodopa dose （95% CI 1. 000-1. 004, OR = 1. 002, P 〈 0. 05 ） were independent factors with dyskinesia; while the age of onset （ OR = 0. 922, P 〈 0. 05 ）, levodopa treatment duration（ OR = 1. 234, P 〈 0.05 ）, daily levodopa dose （95 % CI 1. 002--1. 008, OR = 1. 005 ,P 〈 0. 01 ） and Hoehn-Yahn stage （ OR = 1. 869, P 〈 0. 05 ） were independent factors of motor fluctuations. Conclusions The rate of motor complications was lower than the results surveyed in European countries. The likelihood of occurrence of dyskinesia and motor fluctuations is increased in those on high daily levedopa dose. The concomitant use of other medication to reduce levedopa dose might delay the motor complications.

关 键 词：帕金森病 运动失调 患者 临床分析 

分 类 号：R686[医药卫生—骨科学]