起病年龄对帕金森病运动并发症的影响  

Relation between onset age and the motor complications involved in Parkinson＇ s disease

作　　者：马敬红[1] 邹海强[3] 胡国华[4] 王枫[1] 孙菲[2] 陈彪[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]首都医科大学宣武医院社会医学部,北京100053 [3]广州军区广州总医院神经内科 [4]吉林大学第二医院神经内科

出　　处：《中华神经科杂志》2009年第1期50-52,共3页Chinese Journal of Neurology

基　　金：国家高技术研究发展计划资助项目（2006AA02A408）;国家重点基础研究发展计划资助项目（2006CB500701）;国家科技攻关计划资助项目（2004BA702B02）.

摘　　要：目的探讨起病年龄对帕金森病（PD）患者运动并发症的影响。方法选取确诊为原发性PD且对左旋多巴制剂有效的195例患者进行随访，详细记录其发病年龄、运动并发症出现的时间等临床资料，并对所得资料进行统计学分析。结果195例患者中57例早发和138例晚发患者平均起病后（3．88±3．33）年和（2．36±2．21）年开始服用左旋多巴制剂，两者相比较差异有统计学意义（t=3．142，P=0．002）。早发和晚发患者由开始使用左旋多巴制剂到出现运动并发症的时间分别为（3．81±2．06）年和（4．24±2．00）年，两者相比较差异无统计学意义（t=-0．888，P=0．378）。早发和晚发患者在开始用药时选择非左旋多巴制剂的比例分别为28．07％（16／57）和27．54％（38／138），两者相比较差异无统计学意义（Х^2=0．006，P=0．940）。早发和晚发患者在出现运动并发症时每天服用左旋多巴制剂的平均药量（mg）是601．8±296．7和655．6±192．5。两者相比较差异无统计学意义（t=-0．912，P=0．365）。40岁以下发病的患者用药5年后运动并发症的发生率为7／10，71岁以上的患者为1／10。结论早发患者推迟左旋多巴制剂的使用并不一定能延缓运动并发症的出现。早发患者易于出现运动并发症可能与其用药剂量和始用药物关系不大。发病年龄越早越易出现运动并发症，而70岁以后发病的患者出现运动并发症的危险性显著降低。Objective To observe the involved Parkinson＇ s disease （ PD ） . Methods relation between onset age and the motor complications The detailed clinical information of 195 patients with idiopathic PD and good response to L-dopa were recorded and followed up. The data were calculated with SPSS statistic software. Results Although the time interval between the onset of the disease and the use of L-dopa was significantly longer in the 57 early-onset patients as compared to the 138 later-onset ones （ （3.88 ±3. 33 ） years vs （2. 36 ±2. 21 ） years, t = 3. 142, P = 0. 002）, the time interval between the use of L-dopa and the occurrence of motor complications was not significantly longer in the early-onset group （ （3.81 ±2. 06） years vs （4. 24 ±2. 00） years, t = -0. 888, P =0. 378）. There was no difference in the constituent ratio of non-L-dopa use from onset between early-onset and later-onset PD groups （ 28.07% （ 16/57 ）vs 27. 54% （38/138）,Х^2 = 0. 006, P = 0. 940）. There was also no difference in the dosage of daily L-dopa use when motor complications occurred between early-onset and later-onset PD groups （ （601.8 ±296. 7） mg vs （655. 6 ±192. 5） mg, t = -0. 912, P =0. 365）. Seven-tenths of the patients with an onset age younger than 40 years old carried the risk of motor complications after using L-dopa for 5-years and those older than 70 years had the risk at a rate of 1/10. Conclusions Delaying the of use of L-dopa may not necessarily delay the onset of motor complications. The high incidence of motor complications among younger patients may not be related with drug dosage and the type of drug firstly chosen. Younger onset age does increase the incidence of motor complications.

关 键 词：帕金森病 运动失调 发病年龄 

分 类 号：R686[医药卫生—骨科学]