社区老年帕金森病前驱期调查易患基因多态性研究及康复干预效果  

Study on polymorphism of susceptible genes in elderly patients with Parkinson's disease and effect of rehabilitation intervention

作　　者：李爱东[1] 杨长贵[2] 蔡思敏[1] 刘翠仪 陈川[1] 郑名烺 Li Aidong;Yang Changgui;Cai Simin;Liu Cuiyi;Chen Chuan;Zheng Minglang(Department of Rehabilitation Medicine,Eighth Hospital,Sun Yat-sen University,Futian District,Shenzhen 518033,China;Community Management Center,Eighth Hospital,Sun Yat-sen University,Futian District,Shenzhen 518033,China;Managment Center of Community Health Service,Futian District,Shenzhen 518000,China)

机构地区：[1]中山大学附属第八医院康复医学科,深圳518033 [2]中山大学附属第八医院社管中心,深圳518033 [3]深圳市福田区社区健康服务管理中心,518000

出　　处：《国际医药卫生导报》2020年第14期2014-2017,共4页International Medicine and Health Guidance News

基　　金：深圳市科技创新委员会项目(JCYJ20170307110432752);深圳市福田区卫生公益性科研项目(FTWS2017023)。

摘　　要：目的通过社区老年帕金森病(PD)前驱期调查,进行患者易患基因多态性研究,并分析康复干预对患者的治疗效果。方法选取2016年8月至2017年9月福田区属医院接收的40位PD前驱期患者作为研究对象,将研究对象随机分为研究组和对照组,各20例。两组先进行帕金森病前驱期症状筛查,而后研究组进行康复干预,对照组进行常规健康随访以及生活方式干预。对两组患者进行R1628P基因多态性检测,头颅核磁共振(MRI)检测两组干预前、后脑部病变,非运动症状问卷(NMSQ)、简易智力评价表MMSE、神经精神症状问卷(NPI)用来评价患者认知功能。结果研究组干预后共有5项NMS阳性率明显低于对照组,差异具有统计学意义(P<0.05)。研究组康复干预后MMSE评分显著高于对照组,差异具有统计学意义(P<0.05)。LRRK2基因R1628P位点经过PCR扩增后产物长度512 bp。经随机测序比对后发现PD前驱期患者R1628P位点突变GC型及CC型。经康复干预后,研究组颅脑病变发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论PD前驱期患者在经过运动功能训练和康复训练后,患者的脑部病变情况不仅得到了控制,同时患者的认知能力和生活质量得到有效提高,在临床康复中价值较高,可推广应用。Objective Through a prodromal survey of elderly patients with Parkinson's disease in the community,to analyze the susceptibility genes and the therapeutic effect of rehabilitation intervention.Methods 40 patients with PD during prodromal stage treated from August,2016 to September,2017 in Futian District Hospital were selected as the research objects,and were randomly divided into a study group and a control group,with 20 cases in each group.Both groups were screened for symptoms of PD during prodromal stage,then the study group took rehabilitation intervention,and the control group routine health follow-up and lifestyle intervention.R1628P gene polymorphism was detected in the patients.Brain magnetic resonance imaging(MRI)was used to detect their brain function before and after the intervention.Non-motor symptoms questionnaire(NMSQ),simple intelligence evaluation form MMSE,and neuropsychiatric symptoms questionnaire(NPI)were used to evaluate their cognitive function.Results The positive rates of 5 NMS items were lower in the study group than in the control group,and the difference was statistically significant(P<0.05).After the rehabilitation intervention,the MMSE score was significantly higher in the study group than in the control group(P<0.05).The R1628P site of LRRK2 gene was expanded by PCR,and the product’s length was 512 bp.After random sequencing,the mutations on R1628P site in the patients with PD during prodromal stage were found to be GC and CC.The incidence of craniocerebral lesions in the study group was significantly lower than that in the control group(P<0.05).Conclusion After the motorization and rehabilitation trainings,PD patients’brain lesions are under control,and their brain function,cognitive function,and quality of life improved.Therefore,rehabilitation exercises are worthy of clinical application.

关 键 词：帕金森病前驱期 基因多态性 康复干预 

分 类 号：R742.5[医药卫生—神经病学与精神病学]