非运动症状量表鉴别药物诱发的帕金森综合症的可行性研究  

A Feasibility Study on the Use of the Non-motor Symptoms Scale to Differentiate Drug-induced Parkinsonism

作　　者：王华捷 袁江[1] 朱敬[2] 王自涵 任凤 王丽 王云甫[4] WANG Huajie;YUAN Jiang;ZHU Jing;WANG Zihan;RENG Feng;WANG Li;WANG Yunfu(Department of Neurology,Taihe Hospital,Hubei University of Medicine,Hubei Shiyan 442000,China;Institute of Neuroscience,Hubei University of Medicine,Hubei Shiyan 442000,China;School of Basic Medical Sciences,Hubei University of Medicine,Hubei Shiyan 442000,China;Hubei University of Medicine,Hubei Shiyan 442000,China)

机构地区：[1]湖北医药学院附属太和医院神经内科,湖北十堰442000 [2]湖北医药学院神经科学研究所,湖北十堰442000 [3]湖北医药学院基础医学院,湖北十堰442000 [4]湖北医药学院,湖北十堰442000

出　　处：《神经损伤与功能重建》2025年第4期203-206,232,共5页Neural Injury and Functional Reconstruction

基　　金：湖北省自然科学基金项目(Notch1介导线粒体自噬影响Treg细胞功能参与重症肌无力发病的机制研究,No.2024AFB818);湖北医药学院研究生科技创新项目[T细胞免疫球蛋白黏蛋白-4(TIM-4)调控小胶质细胞极化(M1/M2)对脑出血的影响,No.YC2023051]。

摘　　要：目的:探讨使用非运动症状量表(non-motor symptoms scale,NMSS)协助鉴别药物诱发的帕金森综合症(drug-induced parkinsonism,DIP)与帕金森病(Parkinson's disease,PD)的可行性。方法:选取2023年5月~2024年5月就诊于我院神经内科的DIP患者21例(DIP组),未经药物治疗的PD患者25例(PD组)及无帕金森症状的患者22例(对照组)。收集患者临床资料,使用统一帕金森量表Ⅲ(UPDRSⅢ)和Hoehn-Yahr分级量表(Hoehn and Yahr stage scale,H-Y)对患者进行评估,同时使用NMSS对非运动症状进行评估;比较、分析3组患者的各量表得分及相关性。结果:DIP组、PD组的NMSS单项得分与对照组相比差异显著,除感知(被害妄想、复视),注意力、记忆力(近事记忆困难、遗忘做一些事情),胃肠道症状(吞咽困难),其他(出汗增多)外,其他项目得分差异均有统计学意义(P<0.05)。DIP组和PD组相比,两者的血管症状,睡眠体力(白天嗜睡、不安腿),注意力记忆力(注意力不集中),胃肠道症状(流涎),泌尿系症状,性功能,其他(不能解释的疼痛、味觉嗅觉改变)项目得分差异有统计学意义(P<0.05);Spearman相关分析结果显示,DIP组和PD组的运动症状相关性(UPDRSⅢ和H-Y)低到中度相关(rs=-0.254,-0.519);其他各项中,DIP组只有睡眠体力(白天嗜睡),注意力记忆力(注意力不集中),泌尿系症状,其他(味觉及嗅觉改变)与PD组呈中等程度相关(rs=0.370~0.497);睡眠体力(不宁腿)与PD组为低等程度相关(rs=0.279);其余项目均未发现显著相关性(P>0.05)。结论:NMSS评分有助于提高鉴别早期DIP和PD患者的准确性。Objective:To explore the feasibility of using the Non-motor Symptoms Scale(NMSS)to assist in differentiating drug-induced parkinsonism(DIP)from Parkinson's disease(PD).Methods:A total of 21 patients with DIP(DIP group),25 patients with PD who had not received medication treatment(PD group),and 22 patients without Parkinson's symptoms(control group)were selected from May 2023 to May 2024 in the Department of Neurology of our hospital.Clinical data of the patients were collected,and they were assessed using the Unified Parkinson's Disease Rating Scale Part III(UPDRS III)and the Hoehn and Yahr Staging Scale(H-Y).At the same time,the NMSS was used to evaluate the non-motor symptoms.The scale scores and their correlations among the three groups were compared and analyzed.Results:The scores of the NMSS in the DIP group and PD group showed significant differences compared with the control group.Except for perception(delusions of persecution,diplopia),attention and memory(difficulty remembering recent events,forgetting to do some things),gastrointestinal symptoms(dysphagia),and others(increased sweating),the differences in other items were statistically significant(P<0.05).Compared with the PD group,the scores of vascular symptoms,sleep and physical strength(daytime sleepiness,restless legs syndrome),attention and memory(inattentiveness),gastrointestinal symptoms(ptyalism),urinary symptoms,sexual function,and others(unexplained pain,alteration of taste and smell sense)in the DIP group were statistically significant(P<0.05).Spearman correlation analysis showed that the motor symptoms correlation(UPDRS III and H-Y)in the DIP group and PD group was low to moderately correlated(rs=-0.254,-0.519).Among other items,only sleep and physical strength(daytime sleepiness),attention and memory(inattentiveness),urinary symptoms,and others(alteration of taste and smell senses)in the DIP group were moderately correlated with those in the PD group(rs=0.370~0.497);sleep and physical strength(restless legs syndrome)was lowly correlated wi

关 键 词：帕金森病 药物诱发的帕金森综合症 非运动症状 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学] R742