女性帕金森病患者异动症临床特征和危险因素分析  

Clinical features of dyskinesis and related risk factors in female patients with Parkinson disease

作　　者：赵静[1] 王彦宏[2] 陈佳琦 马少辰 李继来[1] 王培福[1] 杜继臣[1] 冯涛[3] 万志荣[1] ZHAO Jing;WANG Yanhong;CHEN Jiaqi(Department of Neurology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院神经内科,北京100049 [2]航天中心医院老年一科,北京100049 [3]首都医科大学附属北京天坛医院神经病学中心运动障碍性疾病科,北京100070

出　　处：《中风与神经疾病杂志》2025年第2期109-114,F0002,共7页Journal of Apoplexy and Nervous Diseases

基　　金：航天中心医院科研基金项目(YN202403)。

摘　　要：目的调查女性帕金森病(PD)患者异动症的临床特征和相关危险因素。方法采用横断面研究方法,连续收集航天中心医院PD专病门诊符合PD诊断标准的女性患者病例资料,记录一般人口学资料和临床特征数据:左旋多巴等效剂量(LEDD)、UPDRS-Ⅲ、UPDRS-Ⅳ及认知、抑郁等非运动症状评分、是否合并异动症、发生异动症单次左旋多巴剂量(LD),进行组间比较,采用二元Logistic回归分析女性PD患者异动症的影响因素。结果共收集146例女性PD患者,出现异动症30例,发生率20.5%;异动症组与无异动症组临床特征比较,异动症组发病年龄更早[(54.3±12.5)岁vs(62.7±10.0)岁,P<0.001]、病程更长[(9.9±3.7)年vs(4.5±3.7)年,P<0.001]、病情更重[H-Y分期(2.65±0.58)vs(2.35±0.83),P=0.03]、LD服用时间更长[(7.5±3.2)年vs(3.2±2.6)年,P<0.001]、LEDD更高[(703.2±203.9)mg vs(442.1±226.3)mg,P<0.001]、体重更低[(54.1±8.2)kg vs(60.0±8.7)kg,P=0.001]、BMI更低[(20.9±3.1)kg/m^(2)vs(23.4±3.1)kg/m^(2),P<0.001]。多因素Logistic回归分析,BMI高(OR=0.770,P=0.005)是女性PD患者发生异动症的保护因素,而病程长(OR=1.304,P=0.001)、LEDD高(OR=1.003,P=0.012)是女性患者出现异动症的危险因素。结论女性PD患者有较高异动症的发生率,值得临床重视,高BMI是保护因素,病程长、LEDD高是其异动症发生的危险因素。Objective To investigate the clinical features of dyskinesia and related risk factors in female patients with Parkinson disease(PD).Methods A cross-sectional study was conducted among the female patients who met the diagnostic criteria for PD at the outpatient service of PD in Aerospace Center Hospital,and demographic data and clinical data were collected and compared between groups,including levodopa equivalent daily dose(LEDD),Unified Parkinson’s Disease Rating Scale-Ⅲ(UPDRS-Ⅲ),UPDRS-Ⅳ,scores of non-motor symptoms(cognition and depression),presence or absence of dyskinesia,and single levodopa dose(LD)during the onset of dyskinesia.A binary logistic regression analysis was used to investigate the influencing factors for dyskinesia in female patients with PD.Results A total of 146 female PD patients were enrolled,among whom 30 patients had dyskinesia,with an incidence rate of 20.5%.Compared with the non-dyskinesia group in terms of clinical features,the dyskinesia group had a significantly younger age of onset[(54.3±12.5)years vs(62.7±10.0)years,P<0.001],a significantly longer disease duration[(9.9±3.7)years vs(4.5±3.7)years,P<0.001],a significantly higher severity of disease[H-Y stage:(2.65±0.58)vs(2.35±0.83),P=0.03],a significantly longer duration of LD administration[(7.5±3.2)years vs(3.2±2.6)years,P<0.001],a significantly higher LEDD[(703.2±203.9)mg vs(442.1±226.3)mg,P<0.001],and significantly lower body weight[(54.1±8.2)kg vs(60.0±8.7)kg,P=0.001]and BMI[(20.9±3.1)kg/m^(2)vs(23.4±3.1)kg/m^(2),P<0.001].The multivariate logistic regression analysis showed that high BMI(OR=0.770,P=0.005)was a protective factor against dyskinesia in female PD patients,while long disease duration(OR=1.304,P=0.001)and high LEDD(OR=1.003,P=0.012)were risk factors for dyskinesia.Conclusion There is a relatively high incidence rate of dyskinesia in female PD patients,which should be taken seriously in clinical practice,and high BMI is a protective factor,while long disease duration and high LEDD are risk factors

关 键 词：帕金森病 女性 异动症 危险因素 左旋多巴 

分 类 号：R742.5[医药卫生—神经病学与精神病学]