帕金森病患者消化系统相关症状及影响因素分析  

Digestive system related symptoms in patients with Parkinson′s disease and influencing factors

作　　者：秦晓凌[1] 辛在娥[1] 李雪 李再利[1] 刘学奎[1] 罗蔚锋[3] 刘春风[3] Qin Xiaoling;Xin Zaie;Li Xue;Li Zaili;Liu Xuekui;Luo Weifeng;Liu Chunfeng(Department of Neurology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China;Department of Neurobiology,Basic Medical College,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Neurology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]江苏省徐州市中心医院神经内科,221009 [2]江苏省徐州医科大学基础医学院神经生物系,221004 [3]江苏省苏州大学附属第二医院神经内科,215004

出　　处：《中华神经科杂志》2019年第8期607-612,共6页Chinese Journal of Neurology

基　　金：徐州市科技计划项目(KF17091).

摘　　要：目的对早中期帕金森病患者和健康体检者进行消化系统相关症状的问卷调查,观察消化系统相关症状的发生率,分析其影响因素。方法收集在徐州市中心医院就诊并长期随访的早中期帕金森病患者(Hoehn-Yahr分期1~3期)108例,利用帕金森病非运动症状评价量表(Parkinson′s Disease Non-Motor Symptom Scale, PD-NMSS)和自主神经量表(the Scale for Outcomes in Parkinson′s Disease for Autonomic Symptoms, SCOPA-AUT)中有关消化系统相关症状共7项(味觉异常、吞咽困难或呛咳、流涎、易饱或早饱、便秘、便溏、大便失禁)及另外增加的5项消化系统相关症状(无食欲、口干、口腔疼痛、恶心、呕吐5项)共12项症状,对患者进行问卷调查。收集我院体检中心同期健康体检者76名作为对照组,进行相同的问卷调查。结果帕金森病组与对照组在年龄、性别、身高、体重、体重指数等方面差异无统计学意义(均P>0.05)。108例早中期帕金森病患者的消化系统相关症状中,常见口干64例(59.26%)、便秘53例(49.07%)和味觉异常40例(37.04%);其次为无食欲35例(32.41%)和早饱感26例(24.07%);再次为吞咽困难20例(18.52%)、恶心11例(10.19%)、流涎10例(9.26%)、口腔疼痛7例(6.48%)、呕吐4例(3.70%)、便溏1例(0.87%)、大便失禁0例。76名对照的消化系统相关症状中味觉异常13例(17.11%)、早饱感6例(7.89%)、无食欲6例(7.89%)、恶心5例(6.58%)、流涎3例(3.95%)、口腔疼痛1例(1.32%),其余症状为0。两组比较,便秘(χ^2=52.390,P<0.01)、口干(χ^2=69.050,P<0.01)、早饱感(χ^2=8.128,P=0.004)、无食欲(χ^2=16.010,P<0.01)、味觉异常(χ^2=8.642,P=0.003)和吞咽困难(χ^2=15.790,P<0.01)的发生率差异有统计学意义。对影响因素的分析发现,男性对于便秘(95%CI 1.371~7.495,OR=3.205)、早饱感(95%CI 4.227~282.913,OR=34.582)、味觉异常(95%CI 6.620~88.942,OR=24.260)、吞咽困难(95%CI 2.784~88.475,OR=22.906)有影响,其他如年龄、体重Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson′s disease (PD) and healthy subjects, and investigate the incidence of the symptoms and the influencing factors. Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time. A questionnaire, including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities, swallowing disorders, salivation, easy or early satiety, constipation, loose stools, fecal incontinence), and additional five items of digestive system related symptoms (loss of appetite, dry mouth, oral pain, nausea, vomiting), totally 12 items, was used in a survey on PD patients. Seventy-six healthy subjects in the physical examination center of the hospital served as control group, and conducted the same questionnaire survey. Results There was no statistically significant difference in age, gender, height, weight, body mass index (BMI) between the PD and control groups. In 108 PD patients, dry mouth accounted for 64 cases (59.26%), constipation 53 cases (49.07%) and taste abnormalities 40 cases (37.04%), followed by loss of appetite 35 cases (32.41%) and early satiety 26 cases (24.07%), swallowing disorders 20 cases (18.52%), nausea 11 cases (10.19%), salivation 10 cases (9.26%), oral pain seven cases (6.48%), vomiting four cases (3.70%), loose stools one case (0.87%). In 76 controls, taste abnormalities accounted for 13 cases (17.11%), early satiety six cases (7.89%), loss of appetite six cases (7.89%), nausea five cases (6.58%), salivation three cases (3.95%), oral pain one case (1.32%), and the rest zero. The incidence of constipation (χ^2=52.390, P<0.01), dry mouth (χ^2=69.050, P<0.01), early satiety (χ^2=8.128, P=0.004), loss of appetite (χ^2=16.010, P<0.01), taste abnormalities (χ^2=8.642, P=0.003) and swallowing disorders

关 键 词：帕金森病 非运动症状 消化系统相关症状 

分 类 号：R742.5[医药卫生—神经病学与精神病学]