摘要
目的探讨帕金森病(PD)患者自主神经功能障碍(AutD)的影响因素。方法收集2016年5月~2020年5月就诊于我科的PD患者127例,采用统一PD评价量表(UPDRS)、Hoehn-Yahr(H-Y)分期、汉密尔顿焦虑14项量表(HAMA_(14))、汉密尔顿抑郁24项量表(HAMD_(24))、匹兹堡睡眠质量指数(PSQI)、自主神经症状量表(SCOPA-AUT)、皮肤交感反应(SSR)对其进行评估。采用Spearman相关分析评估PD患者SCOPA-AUT总分、SSR与相关指标的相关性。采用线性回归和logistic回归分析影响PD患者AutD的独立危险因素。结果纳入患者经SCOPA-AUT评估均存在AutD,其中以便秘症状最为常见(72.44%)。SSR异常的检出率为66.9%。病程长、焦虑、抑郁、有睡眠障碍的PD患者SCOPA-AUT评分更高(P<0.05)。SCOPA-AUT评分与年龄、病程、H-Y分期、HAMA_(14)评分、HAMD_(24)评分、PQSI均呈正相关(P<0.05);SSR与年龄、HAMD_(24)评分均呈正相关(P<0.05)。年龄、H-Y分期、焦虑情绪为PD患者SCOPA-AUT评分高的独立危险因素(P<0.05);年龄、抑郁为SSR异常的独立危险因素(P<0.05)。结论PD患者AutD发生率高,与患者年龄、焦虑、抑郁情绪等因素密切相关,且病程、焦虑、抑郁情绪、睡眠质量均可加重PD患者的AutD。
Objective To investigate the influencing factors of autonomic dysfunction(AutD)in patients with Parkinson’s disease(PD).Methods Clinical data of 127 PD patients who were treated in our department from May 2016 to May 2020 were collected.Unified Parkinson Disease Rating Scale(UPDRS),Hoehn-Yahr(H-Y)stage,Hamilton Anxiety Scale-14(HAMA_(14)),Hamilton Depression Scale-24(HAMD_(24)),Pittsburgh Sleep Quality Index(PSQI),the Scale for Outcomes in PD for Autonomic Symptoms(SCOPA-AUT)and skin sympathetic response(SSR)were used to evaluate the PD patients.Spearman correlation analysis were used to evaluate the correlation between SCOPA-AUT total score,SSR and related indexes in PD patients.Linear regression and binary logistic regression were used to analyze the independent risk factors affecting AutD in PD patients.Results AutD was found in all patients assessed by SCOPA-AUT,and constipation was the most prominent(72.44%).The detection rate of SSR abnormalities was 66.9%.The SCOPA-AUT score in PD patients with long course of disease,anxiety,depression and sleep disorder were higher(P<0.05).SCOPA-AUT score was positively correlated with age,course of disease,H-Y stage,HAMA_(14),HAMD_(24)and PQSI(P<0.05).SSR was positively correlated with age and HAMD_(24)(P<0.05).Age,H-Y stage and anxiety were the independent risk factors of high SCOPA-AUT score in PD(P<0.05).Age and depression were the independent risk factors of SSR abnormalities(P<0.05).Conclusion The incidence of AutD in PD patients is high,which is closely related to age,H-Y stage,anxiety,depression and other factors.The course of disease,anxiety,depression and sleep quality aggravate the AutD in PD patients.
作者
张永志
刘义晗
王文婷
刘惠苗
顾平
Zhang Yongzhi;Liu Yihan;Wang Wenting;Liu Huimiao;Gu Ping(Department of Neurology,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)
出处
《临床内科杂志》
CAS
2022年第6期386-390,共5页
Journal of Clinical Internal Medicine
基金
河北省卫生健康委员会科研基金资助项目(20210310)
河北省科技厅民生科技专项河北省重点研发计划资助项目(20377721D)
关键词
帕金森病
自主神经功能障碍
焦虑抑郁
睡眠质量
Parkinson’s disease
Autonomic dysfunction
Anxiety
Depression
Sleep quality
作者简介
通讯作者:顾平,E-mail:gpwh2000@126.com
