中风与神经疾病杂志2024，Vol.41Issue(11)：963-968,6.DOI:10.19845/j.cnki.zfysjjbzz.2024.0183
不同运动亚型帕金森病自主神经功能障碍及其与生活质量的关系临床研究
A clinical study of autonomic dysfunction in different motor subtypes of Parkinson disease and its association with quality of life
摘要
Abstract
Objective To investigate the features of autonomic nervous function symptoms in patients with different motor subtypes of Parkinson disease(PD)and the impact of autonomic dysfunction on quality of life in patients with different motor subtypes of PD.Methods Basic information was recorded for all patients enrolled in this study,including the scores of both motor and non-motor symptoms.The patients were divided into different subtypes based on tremor-dominant(TD)and postural instability and gait difficulty(PIGD)scores.Motor and non-motor symptoms,especially autonomic symptoms,were compared between the patients with TD subtype and those with PIGD subtype,and the association between autonomic dysfunction and quality of life was analyzed for patients with different motor subtypes.Results There were 105 patients(57.7%)in the TD group and 63(34.6%)in the PIGD group.There were no significant differences between the TD group and the PIGD group in age,sex,lifestyle,course of disease,levodopa equivalent dose,and disease severity,and there were also no significant differences between the two groups in the scores of anxiety,depression,apathy,cognition,and constipation,the reduction in systolic blood pressure(SBP)in standing and supine positions,and the incidence rate of orthostatic hypotension before and after medication.The PIGD group had a significantly higher total score of autonomic nervous function than the TD group,with a median of 24 and 19,respectively.The median of quality of life score was 66 points in the PIGD group and 46 points in the TD group,suggesting that the PIGD group had a poorer quality of life than the TD group.Quality of life was positively correlated with autonomic nervous function symptoms in the PD patients in both the PIGD group(R2=0.209,P=0.000)and the TD group(R2=0.166,P=0.000).In the TD group,quality of life was correlated with constipation(r=0.313,P=0.002)and the maximum difference in SBP in standing and supine positions before Madopar administration(r=0.252,P=0.009).Conclusion PD patients with PIGD subtype tend to have more severe symptoms of autonomic dysfunction and a lower quality of life than those with TD subtype.PD patients with both TD and PIGD subtypes tend to have a worse quality of life due to severe autonomic dysfunction,and the quality of life of patients with TD subtype is also correlated with constipation and the maximal difference in SBP in standing and supine positions before Madopar administration.关键词
帕金森病/运动亚型/非运动症状/自主神经功能障碍/生活质量Key words
Parkinson disease/Motor sub-type/Non-motor symptom/Autonomic dysfunc-tion/Quality of life分类
临床医学引用本文复制引用
柳竹,王雪梅,王展,杨雅琴,朴英善,冯涛..不同运动亚型帕金森病自主神经功能障碍及其与生活质量的关系临床研究[J].中风与神经疾病杂志,2024,41(11):963-968,6.基金项目
国家自然科学基金青年科学基金项目(81901833) （81901833）
北京市科学技术委员会首都临床特色应用研究青年项目(Z181100001718059) （Z181100001718059）
