帕金森病伴开-关现象的影响因素分析  

Analysis of influencing factors of Parkinson's disease with on-off phenomenon

作　　者：徐萱 张新宁 张凯歌 王垚 薛静 郭冰玉 张含 田浩 陈志刚[1] XU Xuan;ZHANG Xinning;ZHANG Kaige(Department of Encephalopathy,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院脑病一科,100078 [2]西安市中医医院脑病二科 [3]清华大学工程物理系 [4]北京市丰台中西医结合医院脑病科 [5]解放军总医院海南医院康复理疗科

出　　处：《临床神经病学杂志》2025年第2期104-108,共5页Journal of Clinical Neurology

基　　金：高水平能力建设项目“卓远”人才工程国家级人才培育项目(DFRCZY-2024GJRC006);北京中医药大学校级项目(2020-JYB-ZDGG-119);首都卫生发展科研专项项目(首发2018-2-4202)。

摘　　要：目的探讨帕金森病(PD)伴开-关现象的影响因素。方法回顾性选取2021年1月至2023年11月就诊于北京中医药大学东方医院脑病一科门诊及病房的129例PD患者。收集患者临床资料,将患者分为无开-关现象(95例)和有开-关现象(34例),采用二元Logistic回归分析PD患者伴开-关现象的影响因素。结果与无开-关现象的患者相比,有开-关现象的患者病程更长,运动表型以姿势步态异常型多见,合并异动症占比更高,服用左旋多巴等效剂量更高,统一PD评定量表-Ⅱ、匹兹堡睡眠质量指数、Epworth嗜睡量表(ESS)评分更高,差异具有统计学意义(均P<0.05)。二元Logistic回归分析结果显示,运动表型为姿势步态异常型(OR=3.116,95%CI:1.052~9.230)、异动症(OR=11.175,95%CI:1.752~71.301)、ESS评分增高(OR=1.135,95%CI:1.029~1.251)是PD患者伴开-关现象的独立危险因素(均P<0.05)。结论PD患者伴开-关现象是多因素共同作用的结果,其中运动表型为姿势步态异常型、异动症、ESS评分增高是PD患者伴开-关现象的独立危险因素。Objective To investigate the influencing factors of Parkinson's disease(PD)with on-off phenomenon.Methods From January 2021 to November 2023,129 patients with PD who were admitted to the first Department of Encephalopathy in Dongfang Hospital of Beijing University of Chinese Medicine were retrospectively selected.Clinical data of PD patients were collected,and the patients were divided into a group without on-off phenomenon(95 cases)and a group with on-off phenomenon(34 cases).Binary Logistic regression was used to analyze the influencing factors of PD patients with on-off phenomenon.Results Compared with patients without on-off phenomenon,patients with on-off phenomenon had a longer disease course,more movement phenotypes with abnormal posture and gait,a higher proportion of patients with abnormal movements,a higher equivalent dose of levodopa,and higher unified PD rating scale-Ⅱ,Pittsburgh sleep quality index and the Epworth sleeping scale(ESS)scores,the differences of which were statistically significant(all P<0.05).Binary Logistic regression analysis showed that the motor phenotypes of postulatory gait abnormalities(OR=3.116,95%CI:1.052-9.230),dyskinesia(OR=11.175,95%CI:1.752-71.301),high ESS scores(OR=1.135,95%CI:1.029-1.251)were independent risk factors for on-off phenomenon in PD patients(all P<0.05).Conclusion The on-off phenomenon in PD patients is the result of multiple factors,in which the movement phenotype of postural and gait abnormality,dyskinesia,and high ESS scores are independent risk factors for the on-off phenomenon in PD patients.

关 键 词：帕金森病 开-关现象 危险因素 

分 类 号：R742.5[医药卫生—神经病学与精神病学]