帕金森病患者智能障碍及其相关因素分析

目的 研究帕金森病（ＰＤ）患者智能障碍与年龄、性别、病程、脑萎缩、脑功能和了局部血流量（ｒＣＢＦ）的相关性。方法 采用长谷川简易智能评价分度表（ＨＤＳ）测试７６例ＰＤ患者智能,并检查其头颅ＣＴ,脑电地形图（ＢＥＡＭ）和＾１３３Ｘｅ吸入法测定ｒＣＢＦ。结果 智能障碍ＰＤ患者,ＨＤＳ值与年龄呈负相关（ｒ＝－０．７１,Ｐ〈０．０１）,与大脑平均血流量呈正相关（ｒ＝０．６７,Ｐ〈０．０１）;而与性别和病程     

帕金森病患者的情感淡漠及其相关因素分析

目的 探讨帕金森病情感淡漠的患病率、症状学特点及相关因素.方法 收集77例帕金森病患者和40名健康人分为病例组和对照组,使用Lille情感淡漠评定量表(LARS)分别对其进行情感淡漠评分.以-21分为界将病例组分为淡漠组和非淡漠组,对两组的年龄、性别、受教育程度、病程、运动症状、认知损害、抑郁、多巴胺能及精神科药物使用情况进行t检验、x2检验及Logistic 回归分析.结果 77例帕金森病患者中,情感淡漠的发生率为49.4％( 38/77),抑郁的发生率为46.8％( 36/77),其中不伴抑郁的情感淡漠发生率为14.3％ (11/77),情感淡漠同时伴有抑郁的发生率为35.1％ (27/77).在38例情感淡漠患者中,以认知型受损者为主占86.8％ (33/38).帕金森病患者淡漠组(n=38)和非淡漠组(n=39)在受教育程度、统一帕金森病评定量表( UPDRS)Ⅱ和Ⅲ评分、H-Y分级、蒙特利尔认知评估量表和汉密尔顿抑郁量表(HAMD)评分之间差异有统计学意义(t=2.309、-3.144、-4.000、-3.217、2.649、-3.909,均P＜0.05).在情感淡漠相关因素的Logistic回归分析中,依次进入方程的是HAMD评分、UPDRSⅡ和受教育程度.结论 帕金森病患者的情感淡漠发生率高,可独立于抑郁而单独存在,并且可能与患者的受教育程度、运动症状严重程度、认知损害程度及抑郁存在情况之间存在相关性.     

帕金森病患者的抑郁及其相关因素

目的：探讨帕金森病（PD）患者的抑郁发生及相关因素。方法：对50例PD和40例糖尿病（对照组）患者,用汉密顿抑郁量表（HAMD）调查抑郁的发生情况及症状特点。结果：PD组抑郁发生率（485）明显高于对照组（10％）（P＜0．005）,PD组轻度抑郁占58％,中－重度抑郁占42％,抑郁病人病情统一评级标准（UPDS）平均分值57．14;无抑郁病人为35．47（P＜0．01）,Hoehn-YahrⅢ期以上发生抑郁占645;病程＞5年的抑郁发生率为69％,病程＜5年的抑制发生率为11％（P＜0．001）。结论PD患者中有较高的抑郁发生率,其与PD症状严重程度密切相关,病程长者发生率更高。     

帕金森病患者便秘相关因素分析

目的 探讨PD患者便秘的相关因素.方法 选取PD患者212例,采用便秘量表评定PD患者的便秘程度,详细记录患者的年龄、病程、用药情况,并进行UPDRSⅢ评分、Hoehn-Yahr分期、汉密顿抑郁量表(HAMD)评分、中文版简易智能精神状态检查量表(MMSE)评分,将各项因素与便秘进行偏相关分析,并利用二分类Logistic回归分析筛选PD患者合并便秘的危险因素.结果 212例PD患者的年龄、Hoehn-Yahr分期、HAMD总分与便秘有显著的相关关系(P＜0.05),是便秘的危险因素,而性别、病程、盐酸苯海索每日剂量、吡呗地尔每日剂量、左旋多巴每日剂量、UPDRSⅢ评分、MMSE总分与便秘无显著的相关关系(P＞0.05).结论 PD患者便秘与年龄、Hoehn-Yahr分期、HAMD总分有关.     

帕金森病患者认知功能障碍及其相关因素分析

帕金森病 (Ｐａｒｋｉｎｓｏｎｄｉｓｅａｓｅ,ＰＤ)是多见于中老年人的慢性神经系统变性疾病 ,它不仅有严重的运动功能障碍 ,认知功能障碍也很突出。而其认知功能障碍与哪些因素有关 ,仍然是需要研究的问题。我们对 40例ＰＤ患者认知功能进行测查 ,并与病程 ,运动功能障碍 ,受教育年限等因素进行相关性分析。资料 :　随机选择ＰＤ患者 40例 ,男 2 1例 ,女 19例 ,年龄 42～ 71岁 ,平均年龄 (6 0± 6 )岁 ,病程平均 4± 3年 ,平均受教育年限 8± 5年 ,全部患者均经头颅ＣＴ或ＭＲＩ检查 ,除有老年性脑改变外 ,未见特殊异常 ,临床上排除脑血管…     

帕金森病患者伴抑郁的相关因素分析

目的 探讨帕金森病患者发生抑郁的相关因素.方法 对60例帕金森病患者采用汉密尔顿抑郁量表进行测试,并与性别、年龄、病程长短、病情程度等因素进行相关性分析.结果 60例帕金森病患者伴有抑郁的29例(48.3%),帕金森病患者抑郁的发生与患者性别、年龄无关,而与病程长短、病情程度有关.结论 帕金森病患者抑郁发生率较高,其病程长短、病情程度决定着抑郁的程度,对其有明显的影响.     

帕金森病患者视幻觉相关因素分析

目的研究帕金森病(PD)患者视幻觉(VHs)的发生率及相关因素。方法根据是否有VHs将367例PD患者分为VHs组及无VHs组。采用统一帕金森病评分量表第三部分(UPDRS-Ⅲ)、Hoehn-Yahr(H-Y)分期、非运动症状问卷(NMS-Quest)、帕金森病睡眠量表(PDSS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、蒙特利尔认知评估量表(MoCA)评估患者的PD相关病情。结果 VHs组62例(16..9%),其中46例为复杂VHs(74.2%)。与无VHs组比较,VHs组患者病程显著延长,H-Y分期、UPDRSⅢ评分、多巴胺激动剂使用率显著增高(P0.05~0.01)。与无VHs组比较,VHs组患者NMS-Quest总分(除幻觉项)、消化道症状、近记忆/注意力减退、睡眠障碍得分显著升高(均P0.01),MoCA总分、注意力、抽象思维和定向力评分及PDSS量表评分显著降低(P0.05~0.01)。两组间HAMD及HAMA评分差异无统计学意义(均P0.05)。Logistic回归分析发现,病程(OR=1.081,95%CI:1.017~1.148,P=0.012)、使用多巴胺激动剂(OR=1.894,95%CI:1.031~3.482,P=0.040)、近记忆/注意力减退(OR=1.582,95%CI:1.148~2.179,P=0.005)、睡眠障碍(OR=1.388,95%CI:1.111~1.735,P=0.004)是VHs的危险因素;抽象思维(OR=0.620,95%CI:0.391~0.985,P=0.043)、定向力(OR=0.421,95%CI:0.181~0.977,P=0.044)是VHs的保护性因素。结论 VHs是PD患者常见的一种非运动性症状,其发生与PD病程、使用多巴胺受体激动剂、睡眠质量以及认知功能密切相关。     

帕金森病患者睡眠障碍相关因素分析

目的 探讨帕金森病患者睡眠障碍的临床表现及影响其睡眠质量的相关因素.方法 选取无锡市第四人民医院神经内科2009-01-2013-05确诊的帕金森病患者95例,采用匹兹堡睡眠质量指数量表（PSQI）判定患者是否睡眠障碍,通过症状自评量表（SCL-90）比较睡眠障碍有无患者身心健康状况,通过日常生活能力量表（ADL）比较睡眠障碍有无患者之间的差异.结果 本组患者睡眠障碍55例,发生率为58.00%.男女比1∶1.29,女性发生率高于男性,差异有统计学意义（P＜0.05）.其中,≥70岁睡眠障碍患者32例（68.05%）,50～69岁睡眠障碍20例（50.00%）,〈50岁睡眠障碍3例（37.50%）.帕金森病Ⅳ～Ⅴ期患者睡眠障碍39例（39/52,75.00%）,其次发生在Ⅱ～Ⅲ期13例（13/33,39.39%）,发生在Ⅰ期3例（3/10,30.00%）.晚期（Ⅳ～Ⅴ期）帕金森病患者睡眠障碍发生率为75.00%,明显高于早期帕金森病患者的30.00%,差异有统计学意义（P＜0.05）;帕金森病后睡眠障碍患者SCL-90 指标、ADL指标明显差于帕金森病后无睡眠障碍患者,差异均有统计学意义（P＜0.05）.结论 帕金森病患者易发生睡眠障碍,其发生率与性别、年龄、疾病进展程度有关,睡眠障碍可导致患者抑郁、焦虑、生活质量明显下降,临床治疗应做好相应措施.     

帕金森病患者嗅觉减退的相关因素分析

目的 探讨帕金森病患者嗅觉减退的发生率以及相关因素。方法 收集463例帕金森病(PD)患者基本信息,并通过量表系统性评估运动及非运动症状, PD非运动量表“是否有嗅觉减退”项回答“是”者纳入嗅觉减退组,回答“否”者纳入非嗅觉减退组。结果 帕金森病患者嗅觉减退发生率为33.9%,86%的患者嗅觉减退出现在运动症状之前,并且与性别、年龄、起病年龄、运动症状、疾病严重程度无明显关系。伴有嗅觉减退患者的情绪障碍如焦虑、抑郁、淡漠较重,并且睡眠和认知功能较差。高质量的睡眠及吸烟是PD嗅觉减退的保护因素,淡漠是危险因素。结论 合并嗅觉减退患者可能合并更加严重的情绪、睡眠及认知障碍。     

帕金森病患者抑郁的相关因素分析

目的:探讨帕金森病(PD)患者抑郁的发生率以及影响因素。方法:选取52例PD患者,进行汉密尔顿抑郁(HAMD)量表评分、Hoehn-Yahr(H-Y)分级,并对相关因素进行分析。结果:PD患者抑郁的发生率为46.2%(24/52例),H-Y分级、病程以及性别与HAMD评分呈正相关。结论:PD患者抑郁发生率高,且和病情严重程度、病程、性别等因素有关,与左旋多巴日平均剂量和年龄无关。     

帕金森病患者视空间障碍及其相关因素的分析

目的 探讨帕金森病(PD)患者视空间障碍情况及其与相关因素的关系. 方法 选择自2007年4月至6月在广州6家医院门诊或住院部连续就诊并且同意参与本次调查的PD患者共107例,用复制立方体评估PD患者的视空间能力,并选用Hoehn-Yahr分级、PD统一评分量表第2部分(UPDRS-Ⅱ)、UPDRS-Ⅲ、UPDRS-Ⅴ、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HRSD)、Fuld物体记忆测验(FOM)、言语流畅性测验(RVR)、韦氏成人智力量表积木测验(WAIS-BD)、韦氏成人量表数字广度测验(WAIS-DS)、简易精神状态量表(MMSE)、神经精神科问卷(NPI)、睡眠量表、Epworth嗜睡量表(ESS)、非运动并发症等量表评估PD患者的运动症状、神经精神症状、认知及日常生活能力.用Spearman相关分析分析视空间能力与各相关因素的双变量相关性,用二分类Logistic回归分析视空间障碍与相关因素的关系. 结果 在107例PD患者中有59例(55.14%)出现视空间损害.Spearman相关分析表明,视空间能力与发病年龄、性别、Hoehn-Yahr分级、病程、UPDRS-Ⅱ、UPDRS-Ⅲ、FOM、RVR、WISC-BD、WAIS-DS、焦虑状态、痴呆等相关(P＜0.05).经二分类Logistic回归分析发现.Hoehn-Yahr分级及病程是视空间障碍的危险因素,而RVR及WISC-BD是视空间障碍的保护因素. 结论 PD患者视空间障碍的发生可能与病情分级、病程、语言流畅性、图像识别及构造能力等有关,临床上可以通过改善患者运动症状及训练患者的语言能力、图像识别及构造能力等综合治疗来改善患者的视空间能力.     

Use of nutritional supplements in Parkinson's disease patients.

The use of nutritional supplements has almost doubled in the elderly population in the United States (US) in the past decade. We evaluated the use of nutritional supplements in Parkinson's disease (PD) patients to determine the prevalence of their use and whether patients were aware of possible side effects and drug interactions in the supplements they were taking. Consecutively selected PD patients from an academic movement disorders center completed a 33-item questionnaire regarding their use of nutritional supplements. A total of 120 PD patients completed the questionnaire and were included in the data analysis (mean age +/- SD = 68.2 +/- 11.65 years, 67 [55.8%] men and 53 women). Seventy-six patients (63%) took nutritional supplements at the time of data collection. Vitamins were the most common nutritional supplements used, and vitamin E was the most commonly used vitamin. Thirty-six patients (47%) who took nutritional supplements consulted with their doctor before taking them, and only 4% of patients who took nutritional supplements were aware of possible side effects from their use. Twenty patients (16.7%) reported that they were currently taking nutritional supplements because of symptoms related to their Parkinson's disease. The vast majority of PD patients surveyed were not aware that nutritional supplements could cause adverse side effects. Less than half of the patients who took nutritional supplements consulted their physician before starting them. Greater awareness of nutritional supplement use in PD patients is warranted to avoid potentially harmful effects and drug interactions.     

Clinical and psychosocial factors associated with fatigue in patients with Parkinson's disease

Fatigue is an important contributor to poor quality of life. The aim of our research was to identify factors associated with fatigue among patients with Parkinson's disease (PD). The sample consisted of 150 patients. The Multidimensional Fatigue Inventory (MFI), Unified Parkinson's Disease Rating Scale (UPDRS), Hospital Anxiety and Depression Scale (HADS) and Charlson co-morbidity index were used for analysis. Demographic data were obtained in a structured interview. T-test, χ²-test and general linear regression were used. Fatigue was reported in 81% of the patients, with the worst scores in physical fatigue. Mood disorders and worse UPDRS scores were associated with fatigue.     

Mortality in patients with Parkinson's disease

Introduction – After the introduction of L-dopa the mortality rate in Parkinson's disease (PD) patients has changed, but is still higher than in the background population. Material & methods – Mortality, age at death and cause of death in a group of PD patients compared with the background population were studied. The diagnosis on the death certificate were registered. The material consisted of 458 patients who in a period 1.4.1973–31.10.1991 were registered as having PD. Results – Death in the period amounted to 253 patients. Median age of death was 77.29 years for men and 79.11 years for women. In the background population the median age at death was 80.69 years for men and 84.37 years for women. The SMR for men was 1.92 and for women 2.47. Infections, in particular lung infections, and heart diseases were the most common causes of death. Seventy percent of the death certificates had PD as a diagnosis. Conclusion – It is likely that several factors can influence the changed mortality of PD: more effective treatment, changing diagnostic practice, and inter-disease competition.     

Sexual problems in young patients with Parkinson's disease

The purpose of this study was to describe sexual function in a representative group of young patients with Parkinson's disease (PD). Twenty-five patients (15 men, 10 women; agerange 36-56 yrs) participated in a structured interview on sexual function. Forty percent of the men and 70% of the women reported changed libido while 33.4% of the men and 80% of the women experienced changed sexual activity after onset of PD. A tendency to changes in libido and sexual function was seen with increasing time of treatment and advanced Hoehn-Yahr stages. It is concluded that changes in libido and sexual function occur more frequently than previously reported, especially in women, and more attention should be paid to these problems.     

The influence of cerebrovascular risk factors on incident dementia in patients with Parkinson's disease

OBJECTIVE: To examine if risk factors for cerebrovascular disease would increase the risk for dementia in patients with Parkinson's disease (PD). METHODS: Non-demented patients were recruited from an epidemiological study of PD in the county of Rogaland, Norway. PD and dementia were diagnosed according to strict diagnostic criteria. Established cerebrovascular risk factors were recorded at baseline, and their influence on incident dementia was assessed 4 years later using logistic regression analysis. RESULTS: A total of 171 non-demented PD patients constituted the at-risk population. Seventy-two (55%) had at least one cerebrovascular risk factor. A total of 130 subjects (96% of survivors) completed the follow-up examination. Forty-three (33%) new cases of dementia were found. Twenty-five of the 72 (35%) patients with and 18 of the 58 (31%) subjects without any risk factor developed dementia (ns). A significant association with dementia was found for a diagnosis of heart failure in the univariate analyses. However, in the logistic regression analysis none of the cerebrovascular risk factors were significantly associated with incident dementia. CONCLUSIONS: In this large and representative cohort of patients with PD cerebrovascular risk factors were not associated with incident dementia, indicating that the disease-related degenerative brain changes are the main causes of dementia in PD.