脑型肝豆状核变性患者中枢神经系统症状与便秘的相关性研究  

Correlation between central nervous system symptoms and constipation in patients with cerebral hepatolenticular degeneration

作　　者：袁飞燕 方向[2] 金珊[2] 秦雨 郑晓钰 谈露 刘桂章 YUAN Feiyan;FANG Xiang;JIN Shan;QIN Yu;ZHENG Xiaoyu;TAN Lu;LIU Guizhang(Graduate School,Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230000,China;Encephalopathy Center,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230000,China)

机构地区：[1]安徽中医药大学研究生院,合肥230000 [2]安徽中医药大学第一附属医院脑病中心,合肥230000

出　　处：《重庆医学》2023年第17期2602-2605,共4页Chongqing medicine

基　　金：安徽省自然科学基金面上项目(2008085MH264,2208085MH271);安徽省高校自然科学研究重点项目(KJ2019A0457)。

摘　　要：目的探讨脑型肝豆状核变性(WD)患者中枢神经系统症状与便秘的相关性。方法选择2022年5-8月在安徽中医药大学第一附属医院脑病中心治疗的脑型WD患者40例,使用神经系统症状评价量表(改良Young量表)及便秘程度评价量表(CCS量表)对患者进行评分。根据改良Young量表评分进行分组,对各组患者行肛门直肠压力检测及排粪造影检查,以及Pearson相关分析。结果40例患者中共34例便秘,均为Ⅳ型,改良Young量表评分>28分容易出现便秘。A、B、C组患者随着中枢神经系统症状严重程度的加重,CCS评分逐渐升高(F=38.20,P<0.05),最大缩榨压(F=3.43,P<0.05)、直肠力排压(F=23.51,P<0.05)、直肠压力增加(F=18.35,P<0.05)逐渐降低。Pearson相关分析显示,改良Young量表评分与CCS评分呈正相关(r=0.835,P<0.05),与最大缩榨压呈负相关(r=-0.308,P<0.05)、直肠力排压(r=-0.825,P<0.05)、直肠压力增加(r=-0.761,P<0.05)呈负相关。结论大部分脑型WD伴便秘患者存在肠道动力不足,中枢神经系统症状严重程度与便秘呈正相关。Objective To study the relationship between central nervous system symptoms and constipation in patients with cerebral Wilson’s disease(WD).Methods A total of 40 patients with cerebral WD treated in the Encephalopathy Center of The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from May 2022 to August 2022 were selected,and the patients were scored with the central nervous system symptom assessment scale(modified Young scale)and Cleveland Clinic Score(CCS).According to the score of the modified Young scale,the patients were divided into groups,and the anorectal pressure and defecography in each group were tested,as well as Pearson correlation analysis was performed.Results There were 34 cases of constipation in 40 patients,all of which were typeⅣ.The score of modified Young scale was more than 28,which was easy to cause constipation.In group A,B and C,with the severity of symptoms of central nervous system getting worse,CCS score gradually increased(F=38.20,P<0.05),the maximum compression pressure(F=3.43,P<0.05),rectal force discharge pressure(F=23.51,P<0.05),and the increase of rectal pressure(F=18.35,P<0.05)gradually decreased,the differences were statistically significant.The modified Young scale score was positively correlated with CCS score(r=0.835,P<0.05),negatively correlated with maximum compression pressure(r=-0.308,P<0.05),rectal force discharge pressure(r=-0.825,P<0.05),and increased rectal pressure(r=-0.761,P<0.05).Conclusion Most patients with cerebral WD and constipation have insufficient intestinal motility.The severity of central nervous system symptoms is positively correlated with constipation.

关 键 词：肝豆状核变性 脑型 中枢神经系统症状 便秘 

分 类 号：R742.4[医药卫生—神经病学与精神病学]