帕金森病患者非运动症状的发生及对日常生活能力的影响

目的 研究帕金森病(PD)患者非运动症状(NMS)的发生情况,及其对PD患者日常生活能力(ADL)的影响.方法 对107例PD患者进行NMS问卷(NMS Quest)调查,分析NMS的分布状况及临床特征,并采用统一PD评定量表(UPDRS)、Hoehn-Yahr分期、左旋多巴等效剂量、ADL问卷、MMSE评分进行评估,采用多元逐步线性回归探讨NMS对ADL的影响.结果 97.2%(104/107)的PD患者伴发不同程度的NMS,其发生数平均(8±5)个,其中尿频、便秘、记忆力下降最常见,发生率均超过50%;UPDRS-Ⅲ评分(28.0±16.4)分,能解释ADL总分变化的48.1%(R~2=0.481,P=0.000),引入NMS分值后,ADL分值可被解释的部分增加到51.1%.结论 PD患者普遍伴发NMS,而影响患者的ADL.PD可能是由NMS和运动症状共同组成的多系统神经变性疾病.PD患者的NMS在临床上应引起同样的重视,运动症状与NMS同治,才能提高疗效和ADL.

Evaluation non-motor symptoms in Parkinson's disease and its influence on ability of daily living

Objective To evaluate the non-motor symptoms (NMS) in Parkinson's disease (PD),and its influence on ability of daily living (ADL) in PD patients.Methods The NMS questionnaires (NMS Quest) from 107 cases of PD were collected to analyze the NMS.Their clinical phenotypes were assessed by Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn-Yahr Scale,and Mini-mental State examination(MMSE).The levodopa equivalent dosage in their treatment was recorded.ADL questionnaires were also collected for evaluation.Multiple regression analysis was used to determine the influence of NMS on ADL.Results The incidence of NMS was 97.2% (104/107) in PD patients and eight of NMS presented in patients in average.Among them the symptoms of nocturia,constipation and reduced memory were the most frequent ones.The motor score of the UPDRS (28.0 ± 16.4) accounted for 48.1% (R~2 = 0.481,P=0.000) of the variance of ADL score.When the NMS score was included in the model,the R~2 increased to 51.1%.Conclusions The NMS are commonly occurred in PD patients,suggesting that PD is probably a severe multisystemic neurodegenerative disorder composed of motor disorders and NMS.The NMS correlates with lower ADL.The NMS in PD should be taken seriously and PD patients should be treated for both motor dysfunction and NMS to increase treatment effectiveness and the quality of their daily livings.