帕金森病初诊患者自主神经功能障碍临床研究  

Clinical Studies on Autonomic Dysfunction in Patients with Newly Diagnosed Parkinson Disease

作　　者：戚飞腾[1] 章小微 童洋萍[1] 谢甬淋[1] 毕涌[1] 张扬[1] 张旭[1] 

机构地区：[1]温州医科大学附属第一医院神经内二科,浙江省温州市325000

出　　处：《中国全科医学》2014年第9期1001-1004,共4页Chinese General Practice

基　　金：浙江省"十二五"神经生物学重点学科(071006);浙江省自然科学基金(Y2101091);温州市科技计划项目(Y20120005;Y20100275)

摘　　要：目的分析帕金森病初诊患者伴发自主神经功能障碍的特点及其对生活质量的影响。方法选取2010年1月—2013年6月我院神经内二科门诊首次诊断为帕金森病患者70例,采用帕金森病自主神经症状量表(SCOPA-AUT)对患者的自主神经功能状况进行测评;采用Hoehn-Yahr分期(H-Y分期)对病情严重程度进行评估;采用帕金森病统一评定量表(UPDRS)第三部分(UPDRSⅢ)、第二部分(UPDRSⅡ)分别对患者的运动能力、生活能力进行测评;采用帕金森病生活质量问卷(PDQ-39)对患者的生活质量进行测评;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)对患者的精神状况进行测评。结果 70例患者SCOPA-AUT评分为(13.1±9.7)分,50例(71.4%)出现自主神经症状(AS),20例(28.6%)无自主神经症状(NAS)。SCOPA-AUT的6个系统中,各系统症状发生率间有差异(χ2=59.00,P=0.00),其中胃肠道症状发生率为62.9%(44/70),其次为泌尿系统(39例,55.7%)、心血管系统(27例,38.6%)、生殖系统(23例,32.9%)、体温调节(18例,25.7%)和瞳孔调节(6例,8.6%)的症状。AS患者的年龄、H-Y分期及UPDRSⅢ、PDQ-39、HAMA、HAMD评分均高于NAS患者(P<0.05),而UPDRSⅡ评分与NAS患者无差异(P>0.05)。结论帕金森病初诊患者即存在不同程度的自主神经功能障碍,且其对患者的运动能力、生活质量及精神状况均产生影响。Objective To investigate the features of newly diagnosed Parkinson disease（PD） patients with autonomic dysfunction and its impact on the quality of life.Methods A total of 70 newly diagnosed PD patients were recruited from outpatient of the second department of neurology in our hospital from January 2010 to June 2013.The scale for outcome in PD-autonomic（SCOPA-AUT） was used to evaluate the status of autonomic nerve function.Hoehn-Yahr（H-Y） stage scale was used to evaluate severity of disease.The third part of UPDRS,the second part of UPDRS and PDQ-39 were used to evaluate exercise ability,living ability and quality of life separately.HAMA and HAMD were used to evaluate mental condition .Results The average score of SCOPA-AUT in 70 patients was（13.1±9.7）.Autonomic symptom（AS） was found in 50 cases（71.4%） and AS was not found in 20 cases（28.6%）.There were significant differences in prevalences of different system symptoms among six systems of SCOPA-AUT（χ2=59.00,P=0.00）.Among different system symptoms,the highest rate was found in gastrointestinal system（44 cases,62.9%）,followed by urinary system（39 cases,55.7%）,cardiovascular system （27 cases,38.6%）,reproductive system（23 cases,32.9%）,temperature regulation（18 cases,25.7%） and pupil regulation（6 cases,8.6%） symptom.The age,H-Y stage,scores of the third part of UPDRS,PDQ-39,HAMA and HAMD in patients with AS were significantly higher than those in patients without AS（P〈0.05）,but there was no significant difference in score of the second part of UPDRS between patients with AS and patients without AS（P〉0.05）.Conclusion Many newly diagnosed PD patients have different levels of autonomic dysfunction,which affect exercise capacity,the quality of life and mental condition.

关 键 词：帕金森病 自主神经系统疾病 生活质量 

分 类 号：R742.5[医药卫生—神经病学与精神病学]