帕金森病患者自主神经功能障碍评估

目的：评估帕金森病（PD）患者中自主神经功能障碍症状发生比例、各症状分布的差异，及其与PD临床特点之间的关系。方法：应用SCOPA-AUT量表、统一帕金森病评分量表（UPDRS）、日常生活能力量表（ADL）、Hamilton抑郁量表和简易智能量表（MMSE）对116例原发性PD患者进行评估。结果：SCOPA-AUT总分和消化系统（GI）症状、排尿（UR）症状、体温调节（TH）症状、性功能（SX）症状评分均高于对照组，差异有极显著统计学意义（P=0．0001）。SCOPA-AUT总分与UPDRS评分、Hamilton抑郁量表评分呈正相关（P〈0．001），与生活质量ADL评分呈负相关（P〈0．001）。结论：自主神经功能障碍在PD早期就会出现，并随着疾病进展而加重，影响患者的生活质量。

Assessment of Autonomic Dysfunction in Patients with Parkinson's Disease

Aim:To investigate the prevalence,distribution of autonomic dysfunction in patients with Parkinson's disease(PD),and to analyze the relationship between these symptoms and disease-related characteristics.Methods:The Scale for Outcomes in PD for Autonomic Symptoms(SCOPA-AUT),Unified Parkinson's Disease Rating Scale(UPDRS),Activity of Daily Living Scale(ADL),Hamilton Depression Rating Scale for Depression(HRSD) and Mini-mental State Examination (MMSE) were used to evaluate 116 patients with idiopathic PD.The results were taken from PD patients and compared with those of 80 control subjects. Results:PD patients had more total SCOPA-AUT score and domain scores in gastrointestinal,urinary, thermoregulatory and sexual symptoms compared to control subjects(P=0.000 1).All scores increased significantly with developing disease severity except thermoregulatory function.There were significant positive correlations between the total score with UPDRS or HRSD,and negative correlation with ADL(P<0.001). The total score of 16 novo PD patients without treatment higher than that of controls(P=0.000 8), especially on region thermoregulatory(P=0.000 6).There was no relationship among the total score and dose of levodopa,disease duration and sex.Conclusion:Autonomic dysfunction is an important feature of Parkinson's disease,being present early in the disease and increasing with disease severity.It impacts the patients with PD on daily life and functioning quality.