贵州医科大学学报

2018, v.43;No.209(02) 187-191

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帕金森病患者的临床特征及影响运动症状的相关因素
Clinical Features and Influential Factors of Motor Symptoms in Patients with Parkinson's Disease

涂丽;田锦勇;
TU Li;TIAN Jinyong;Guizhou Medical University;Emergency Department of Internal Medicine,Guizhou Provincial People's Hospital;

摘要(Abstract):

目的:探讨帕金森病(PD)的临床特征及PD运动症状的影响因素。方法:收集102例原发性PD患者的一般资料(性别构成、年龄、病程、起病年龄及起病类型),比较运动症状特征(起病肢体、首发症状、H-Y分级、临床亚型),比较各运动症状的发生率、不同药物治疗PD患者比例;采用单因素Logistic回归分析PD运动并发症的影响因素,多因素Logistic回归分析PD运动并发症的独立危险因素。结果:男性患者发病率较高(56.86%),晚发型为主(75.49%),50.00%的患者以右侧肢体起病,65.69%的患者以震颤为首发症状,运动并发症发生率为20.59%,80.39%的患者选用药物为单用左旋多巴(LD),LD治疗的平均时间为(1.55±1.99)年,左旋多巴等效剂量(LED)平均值为(250±143.98)mg,患者病程、H-Y分级、LD、LED用量及联合≥3类药是PD运动并发症的影响因素(P<0.05),LED是PD症状波动的独立危险因素(P=0.02)。结论:PD是以震颤为首发症状、运动症状较重、男性患者为主、以右侧肢体为起病侧为特征,LED是症状波动的独立危险因素。
Objective:To investigate the clinical features of motor symptoms in patients with Parkinson's disease(PD) and the influential factors of motor symptoms of PD,and provide clinical basis for long-term treatment of PD.Methods:The clinical data of 102 PD patients were registered by specially trained neurological physicians.The clinical features of PD patients with different courses were compared,including Hoehn-Yahr(H-Y) staging,clinical subtypes and the onset types,and the correlation among motor symptoms,gender,age,course of disease,H-Y stage,LEDD,clinical subtypes and onset types were analyzed,so as to explore the occurrence and the development rule of motor symptoms and motor complications.Results:Among 102 cases with PD,the incidence of male patients was higher(56.86%),and the ratio of male and female was 1.31∶ 1.Initial symptoms appeared on the right side in 50% patients.The initial symptom of 65.69% patients was tremor.Motor complications occurred in 20.59%.LEDD was an independent risk factor for symptom fluctuation(P = 0.02).Levodopa(LD) was chosen in 80.39% of the patients.The mean duration of LD treatment was 1.55 ±1.99 years,and the mean LEDD was 250 ± 143.98 mg.MAO-B inhibitors and COMT inhibitors were rarely introduced in the patients.Patients without treatment accounted for 1.96%.Conclusions:Motor symptoms of PD patients are severe,and the majority are males.The onset side is in the right limbs and tremor was the primary symptom.Inflexible movements may be an early symptom of PD.LED is an independent risk factor for symptom fluctuations.

关键词(KeyWords): 帕金森病;左旋多巴;运动症状;每日左旋多巴等效剂量;临床特征;回归分析;独立危险因素
Parkinson's disease;Levodopa;motor symptoms;Equivalent dose of daily levodopa;clinical characteristics;regression analysis;independent risk factors

Abstract:

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基金项目(Foundation): 国家自然科学基金(81560201)

作者(Author): 涂丽;田锦勇;
TU Li;TIAN Jinyong;Guizhou Medical University;Emergency Department of Internal Medicine,Guizhou Provincial People's Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2018.02.012

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