早期未治疗帕金森病患者非运动症状调查  

Investiagtion of non-motor symptoms in early untreanted parkinson's disease patients

作　　者：张长国[1] 冯耀耀[1] 陈静[1] 张强春[1] 

机构地区：[1]浙江省湖州市第三人民医院神经内科,313000

出　　处：《中华全科医学》2014年第6期963-964,1008,共3页Chinese Journal of General Practice

摘　　要：目的调查早期未治疗帕金森(PD)患者非运动症状发生及与药物治疗之间的相关性。方法 76名新诊断的未治疗的PD患者,于初诊时及随访2年后于非运动症状问卷(NMS Quest)、UPDRSⅢ量表评定患者的非运动症状及运动障碍症状,所有患者根据临床症状于不同时期接受多巴胺能药物治疗。结果在诊断初,96.1%的患者具有至少一种非运动症状,在2年后的随访中,焦虑与悲伤发生率较基线状态有减少(P=0.003和P=0.003),性生活困难、疼痛、体重改变发生率较前增多(P=0.023,P=0.042和P=0.016)。Spearman’s相关分析示,焦虑与悲伤和是否使用多巴受体激动剂(DA)呈负相关(ρ=-0.478,P=0.01及ρ=-0.364,P=0.020),而体重改变与DA是否使用及多巴胺等效剂量(DA-LEDD)呈正相关(ρ=0.437,P=0.04;ρ=0.326,P=0.001),Logistic回归分析多巴受体激动剂是悲伤的保护性因素(OR=0.836,P=0.001),而是否使用DA及DA-LEDD是体重改变的危险因素(OR=11.2,P=0.007;OR=3.7,P=0.03)。结论在早期的PD患者中非运动症状发生率高且症状持续存在,某些PD治疗药物特别是DA影响着非运动症状的发生。Objective To determine the prevalence of non-motor symptoms in the early stage untreated Parkinson disease （PD） and their relationship with drug therapy. Methods 76 newly diagnosed untreated PD patients were included into this study and each of them were given the Non-Motor Symptoms Questionnaire（ NMS Quest） and The Unified Parkinson＇ s Disease Rating Scale Ⅲ（ UPDRS- Ⅲ ） to evaluate non-motor symptoms and motor disability. At baseline and followed for 2 years. Dopaminergic therapy was started according to the clinical symptoms in different time. Results At baseline, 96.1% patients referred at least one non-motor symptom. At follow-up, anxiety and sad were significantly less frequent at follow-up（ respectively, P = 0. 003 and P = 0. 003 ）, while Sex difficulties （ P = 0. 023 ）, Pain （ P = 0. 042 ） and Weight change（ P = 0. 016） were more frequently. Both Anxiety and Sad were negatively correlated to use of dopamine agonists （DA） （ respectively, Spearman＇ s p = - 0. 478, P = 0.01and Spearman＇ s p = - 0. 364, P = 0.02 ） ; weight change was correlated to use of DA （ Spearman＇ s p = 0. 437, P = 0.04） , and to dopamine agonists-L-Dopa-equivalent daily dosage （DA-LEDD） （Spearman＇ s p = 0. 326 ,P =0.01 ）. The regression model showed a negative correlation between use of DA and sad（ OR =0. 836 ,P = 0. 001 ）, positive significant correlations between Weight change and use of DA（ OR = 11. 2; P = 0. 007 ） and DA-LEDD （ OR = 3.7 ; P = 0.03 ） were found. Conclusion Non-motor symptoms were very frequent in early stage, they tended to remain stable during the early phase of disease, being only few non-motor symptoms affected from dopaminergic therapy, specifically, by the use of dopamine agonists.

关 键 词：帕金森病 非运动症状 随访研究 

分 类 号：R742.2[医药卫生—神经病学与精神病学]