摘要
目的研究帕金森病(PD)患者便秘的患病率和临床特点。方法收集2012年10月―2013年11月间在上海交通大学附属第一人民医院PD专病门诊确诊的143例PD患者的临床资料,对其便秘情况进行分析。比较PD伴便秘患者(便秘组)和不伴便秘患者(无便秘组)的Hoehn-Yahr(H-Y)分期,PD综合评分量表第三部分(UPDRS-Ⅲ)、简易精神状态检查量表(MMSE)、PD睡眠量表第2版(PDSS-2)、汉密尔顿抑郁量表(HAMD)评分,以及多巴胺能药物的应用情况。结果 143例PD患者中,确诊伴发便秘91例(63.6%),其中53.8%(49/91)的患者的便秘症状先于运动症状出现。便秘组患者的H-Y分期、UPDRS-Ⅲ评分、PDSS-2评分均显著高于无便秘组(P值分别<0.01、0.05),UPDRS-Ⅲ迟缓项评分亦显著高于无便秘组(P<0.05)。便秘组中HAMD评分>8分者的比例显著高于无便秘组(P<0.05)。两组间服用多巴胺能药物的疗程、剂量,以及嗅觉减退、认知功能障碍发生率的差异均无统计学意义(P值均>0.05)。结论 PD患者便秘患病率高,PD伴发便秘可影响患者的生活质量。便秘症状先于运动症状出现的比例较高,提示便秘可能是PD的早期症状。
Objective To evaluate the prevalence and clinical characteristics of constipation in patients with Parkinson＇s disease. Methods In the present study 143 patients diagnosed with Parkinson＇s disease in our hospital between October 2012 and November 2013 were followed up by face to face interview. According to the result of constipation, the patients were divided into two groups. The scores of Hoehn and Yahr stage, unified Parkinson＇s disease rating scale part III （UPDRS-III）, mini-mental state examination （MMSE）, Parkinson＇s disease sleep scale （2nd edition, PDSS-2） and Hamilton rating scale for depression （HAMD） and the administration of dopaminergics were compared between the two groups. Results Constipation was diagnosed in 91 Parkinson＇s disease patients （63.6%, 91/143）, and the symptom of constipation preceded motor symptoms in 49 patients （53.8%, 49/91）. The scores of Hoehn and Yahr stage, UPDRS-III and PDSS-2 in the patients with constipation were significantly higher than those in the patients without constipation （ P〈0.05 or P〈0.01 ）. The subscore of retardation in UPDRS-III of patients with constipation was also significantly higher than that of those without constipation （P〈0.05）. The proportion of depression patients （HAMD〉 8） with constipation was significantly higher than those without constipation （ P〈0.05）. But there were no significant differences in terms of the course of treatment, dose of dopaminergics or incidences of hyposmia and cognitive dysfunction between the patients with and without constipation （all P 〉 0. 05）. Conclusion Symptoms of constipation are common in Parkinson＇ s disease patients and can seriously affect quality of life. Motor symptoms appear ahead of constipation in most Parkinson＇s disease patients, which indicates that constipation may be the early symptom of Parkinson＇s disease.
出处
《上海医学》
CAS
CSCD
北大核心
2014年第3期250-253,共4页
Shanghai Medical Journal
基金
国家自然科学基金面上项目(81371410
81171205)
上海交通大学医学院新百人计划
上海市浦江人才项目(11PJD019)资助
关键词
帕金森病
便秘
非运动症状
早期诊断
Parkinson＇s disease
Constipation
Non-motor symptoms
Early diagnosis
