摘要
目的观察合并比萨综合征(Pisa syndrome,PS)的帕金森病(Parkinson’s disease,PD)患者临床特征,探讨PD患者发生PS的影响因素。方法采用巢式病例-对照研究设计方案。于2020年9-12月连续收集重庆医科大学附属第一医院神经内科住院治疗的确诊为PD且不合并脊柱侧向屈曲的患者222例。经过2年随访,筛选合并PS的PD患者26例作为观察组,以1∶4比例按照性别和年龄匹配对照组患者98例。对比分析2组患者人口学、临床特征资料,改良Hoehn-Yahr(H-Y)分级量表、8项帕金森病生活质量问卷(Parkinson’s disease questionnaire-8,PDQ-8)、统一帕金森病评分量表(unified Parkinson’s disease rating scale,UPDRS)、视觉模拟评分(visual analogue scale,VAS)、蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)等评分结果。结果2组在病程、每日左旋多巴等效剂量、药物调整、半年内反复跌倒、H-Y分级、UPDRS-Ⅲ评分、中轴症状评分、肌强直评分、VAS评分、PDQ-8评分、HAMA评分、HAMD评分、MoCA评分上差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PS的发生与中轴症状评分(OR=1.402,95%CI:1.050~1.872,P=0.022)、肌强直评分(OR=1.429,95%CI:1.053~1.937,P=0.022)、VAS评分(OR=1.772,95%CI:1.089~2.883,P=0.021)密切相关。ROC曲线分析结果显示中轴症状评分、肌强直评分、VAS评分的曲线下面积分别为0.899(95%CI:0.844~0.954)、0.835(95%CI:0.747~0.922)、0.827(95%CI:0.748~0.905),约登指数分别为0.681、0.558、0.488。结论PD患者中轴症状、肌强直以及腰背部疼痛的严重程度与PS的发生密切相关。
Objective To observe the clinical characteristics of Parkinson's disease(PD)patients complicated with Pisa syndrome(PS),and to explore the influencing factors for PS occurrence in the PD patients.Methods A nested case-control study was conducted on 222 patients continuously diagnosed with PD but not with lateral spinal flexion admitted in our department from September 2020 to December 2020.After 2 years of follow-up,26 PD patients complicated with PS were assigned into observation group,and 98 sex-and age-matched PD patients without PS complication were assigned into control group in a ratio of 1∶4.Their demographic and clinical data were collected,and the relevant scales and questionnaires were performed,including Hoehn and Yahr(H-Y)Staging Scale,Parkinson's Disease Questionnaire-8(PDQ-8),Unified Parkinson's Disease Rating Scale(UPDRS),Visual Analogue Scale(VAS),Montreal Cognitive Assessment Scale(MoCA),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD).Results There were significant differences between the observation group and the control group in the course of the disease,equivalent daily dose of levodopa,drug adjustment,repeated falls within half a year,H-Y stage,UPDRS-III score,score of axial symptoms,rigidity score,VAS score,PDQ-8 score,HAMA score,HAMD score and MoCA score(P0.05).Multivariate logistic regression analysis showed that the occurrence of PS was closely correlated with score of axial symptoms(OR=1.402,95%CI=1.050~1.872,P=0.022),rigidity score(OR=1.429,95%CI:1.053~1.937,P=0.022)and VAS score(OR=1.772,95%CI:1.089~2.883,P=0.021).ROC curve analysis indicated that the AUC value of score of axial symptoms,rigidity score and VAS score was 0.899,0.835 and 0.827,with a Youden index of 0.681,0.558 and 0.488,respectively.Conclusion The severities of axial symptoms,rigidity and low back pain in PD patients are closely associated with the occurrence of PS.
作者
黄根
曹惠敏
聂湘涛
余刚
HUANG Gen;CAO Huimin;NIE Xiangtao;YU Gang(Department of Neurology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2023年第20期2165-2170,共6页
Journal of Army Medical University
关键词
帕金森病
比萨综合征
姿势异常
运动症状
影响因素分析
Parkinson’s disease
Pisa syndrome
postural deformities
motor symptoms
analysis on influencing factors
