摘要
目的 以初诊未服药的帕金森病(PD)患者为研究对象,探讨初诊不同运动亚型的PD患者嗅觉障碍的差异及其相关影响因素。方法 回顾性选取2018年10月至2022年6月在南京脑科医院初次就诊的125例原发性PD患者,分为震颤为主(TD)型和强直少动(ARD)型两组。比较两组临床资料的差异,分别分析不同亚型PD患者嗅觉评分与MoCA量表评分、HAMD量表评分、HAMA量表评分、UPDRSⅢ评分、帕金森病非运动症状问卷(PDNMS)得分及Hoehn-Yahr(H-Y)分期的相关性;采用多元线性回归分析初诊PD患者发生嗅觉障碍的影响因素。结果 ARD型PD患者UPDRSⅢ评分高于TD型患者,嗅觉评分低于TD型(P<0.05)。TD型HAMD评分是嗅觉评分的独立影响因素(P<0.05);而ARD型嗅觉评分与UPDRSⅢ评分和MoCA量表评分相关(P<0.05),其中MoCA量表评分是嗅觉评分的独立影响因素(P<0.05)。结论 初诊时ARD型患者较TD型患者有更严重的嗅觉障碍,不同运动亚型PD患者的嗅觉功能影响因素不同,结合嗅觉评分和运动亚型预测患者可能面临的其他非运动症状,以利为患者制定个性化的随访和治疗方案。
Aim To investigate the differences in olfactory dysfunction and related factors in de novo Parkinson's disease patients with different motor subtypes.Methods One hundred and twentyfive de novo Parkinson's disease patients who were admitted to the Affiliated Brain Hospital of Nanjing Medical University from October 2018 to June 2022 were retrospectively selected and divided into two groups,tremor-dominant(TD)subtype and akinetic-rigid-dominant(ARD)subtype.The differences in general and clinical data between the two groups were compared.The correlations between olfactory scores and Montreal Cognitive Assessment(MoCA)scores,Hamilton Depression Rating Scale(HAMD)scores,Hamilton Anxiety Scale(HAMA)scores,Unified Parkinson's disease Rating Scale Part IⅡI(UPDRS II)scores,Parkinson's disease Non Motor Symptoms Questionnaire(PDNMS)scores,and Hoehn Yahr(H-Y)stage in different subtypes of patients were analyzed.And linear regression analysis was used to analyze the factors affecting the olfactory disturbance in de novo Parkinson's disease patients.Results UPDRS II scores were higher and olfactory scores lower in ARD PD patients than TD patients(P<0.05).HAMD scores was found to be an independent effect of olfactory score in PD patients with TD(P<0.05).However,the UPDRS II and MoCA scores were correlated(P<0.05)with the olfactory scores of PD patients with ARD,in which the MoCA score was found to be an independent factor(P<0.05).Conclusion De novo Parkinson's disease patients with ARD subtype had more severe olfactory dysfunction than those with TD subtype,and the influencing factors of olfactory function were different in patients with PD of different motor subtypes.And it is necessary to combine olfactory scores and motor subtypes to predict other non-motor symptoms that patients may be confronted with in order to assign personalized follow-up and treatment protocols to patients.
作者
邢逸
闫磊
郑慧芬
孙钰
徐评议
吴钧
刘卫国
XING Yi;YAN Lei;ZHENG Hui-fen;SUN Yu;XU Ping-yi;WU Jun;LIU Wei-guo(Department of Neurology,the Afiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Neurology,Geriatric Hospital of Nanjing Medical University,Nanjing 210024,China;International Laboratory of Pediatric Medical Imaging Research of the Southeast University,Nanjing 210096,China;Department of Neurology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)
出处
《中国临床神经科学》
2023年第4期380-385,417,共7页
Chinese Journal of Clinical Neurosciences
基金
国家重点研发计划项目(编号:2017YFC1310302)
国家自然科学基金项目(编号81571348)
江苏省重点研发计划项目(编号:BE2019611)
江苏省自然科学基金项目(编号:BK20151077)。
关键词
帕金森病
亚型
初诊
嗅觉障碍
抑郁
认知损害
Parkinson's disease
subtype
de novo
olfactory dysfunction
depression
cognitive impairment
