帕金森病患者便秘症状与临床特征和外周免疫间的相关性分析  

Correlation analysis among constipation symptom and clinical features and peripheral immunity of patients with Parkinson's disease

作　　者：安珂[1] 屈艺 王丹蕾 严泳雯 薛峥[2] 李静怡 AN Ke;QU Yi;WANG Danlei(Department of Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉30030 [2]华中科技大学同济医学院附属同济医院全科医学科,武汉30030

出　　处：《临床神经病学杂志》2025年第2期96-103,共8页Journal of Clinical Neurology

基　　金：国家自然科学基金项目(82301621)。

摘　　要：目的探讨帕金森病(PD)患者便秘症状与临床特征和外周免疫间的相关性。方法纳入2019年9月至2021年10月于我院神经内科就诊的135例PD患者。收集相关资料,并根据PD的非运动症状评估量表(NMSS)中便秘项的评估将其分为PD-非便秘组和PD-便秘组,比较两组间临床特征和外周免疫细胞亚群的差异。在PD-便秘组中,分析便秘项得分与各指标间的相关关系。对便秘项得分进行多因素Logistic回归分析确定其独立危险因素。结果与PD-非便秘组相比,PD-便秘组的年龄、发病年龄更大,非运动症状的评分更高,体重、体重指数和认知评分更低,外周血中性粒细胞和嗜碱性粒细胞减少,差异均有统计学意义(均P<0.05)。便秘项得分与外周血总T细胞(CD4 T、CD8 T)的数量呈负相关关系,而与NK细胞的数量呈正相关关系(均P<0.05);体重、体重指数、文化程度、认知评分越高的PD患者的便秘越轻,而年龄、发病年龄、非运动症状评分、焦虑评分越高的PD患者便秘越重(均P<0.05)。Logistic回归分析提示,自主神经功能量表评分(OR=1.108,95%CI:1.013~1.212,P=0.025)和NMSS评分(OR=1.026,95%CI:1.002~1.050,P=0.034)是便秘项得分的独立危险因素。结论PD-便秘组相对而言具有总体年龄偏大、体重偏轻、认知和非运动症状更重的临床特点;便秘症状加重与外周血中T细胞群体数量减少,NK细胞数量增加有关。自主神经功能障碍和非运动症状是影响便秘加重的危险因素。Objective To investigate the correlation among constipation symptom and clinical features and peripheral immunity of patients with Parkinson's disease(PD).Methods A total of 135 PD patients who were admitted to the Department of Neurology in our hospital from September 2019 to October 2021 were included in this study.Their relevant data were collected,and they were divided into the PD-non-constipation group and the PD-constipation group based on the assessment of constipation in the non-motor symptom scale(NMSS)of PD.The clinical features and peripheral immune cell subsets were compared between the two groups.In the PD-constipation group,the correlation between the constipation score and each factor was analyzed.Finally,the independent risk factors of the constipation score were determined by multivariate Logistic regression analysis.Results Compared with the PD-non-constipation group,the PD-constipation group was older in terms of age and age onset,with higher scores in non-motor symptoms,lower weight,body mass index,cognitive scores and fewer neutrophils and basophils in peripheral blood,the differences of which were all statistically significant(all P<0.05).The constipation score was negatively correlated with the number of total T cells(CD4 T,CD8 T)in peripheral blood,and positively correlated with the number of NK cells(all P<0.05).The constipation was lighter in PD patients with higher weight,body mass index,education level,and cognitive scores;while it was heavier in PD patients with older age,age onset,higher non-motor symptoms and anxiety scores(all P<0.05).Logistic regression indicated that scales for outcomes in PD-autonomic(OR=1.108,95%CI:1.013-1.212,P=0.025)and NMSS scores(OR=1.026,95%CI:1.002-1.050,P=0.034)were independent risk factors for the constipation score.Conclusions Compared with PD-non-constipation group,PD-constipation group has the clinical features of overall older age,lighter weight,more severe cognitive and non-motor symptoms.The peripheral blood T cell population is decreased,while th

关 键 词：帕金森病 便秘 免疫细胞 非运动症状 

分 类 号：R742.5[医药卫生—神经病学与精神病学]