Krogh K, Ostergaard K, Sabroe S, Laurberg S
Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark.
Acta Neurol Scand. 2008 Jan;117(1):60-4. doi: 10.1111/j.1600-0404.2007.00900.x.
The clinical importance of bowel symptoms in Parkinson's disease (PD) remains to be described in detail.
A 33-item questionnaire including background parameters, the Cleveland Constipation Score (CCS), and items from the Neurogenic Bowel Dysfunction score was sent to 468 PD patients. Results were compared to a control group (CG) (n = 45). A CCS of at least 15 was used to define severe constipation.
Four hundred and sixteen subjects (89%) responded. Median CSS was only 4 (range 0-21) in PD and 2 (range 0-13) in the CG (P < 0.05). Severe constipation was found in 7% with PD and 0% in the CG (P < 0.05). Incomplete emptying at defecation, need for assisted defecation and use of oral laxatives was reported more frequently by PD patients than by the CG (all P < 0.05). The severity of PD was associated with assisted defecation (P < 0.001), unsuccessful attempts at defecation (P < 0.001), incomplete emptying at defecation (P < 0.05), and the CCS (P < 0.01). Time since diagnosis was associated with infrequent defecation (P < 0.0001) and the CCS (P < 0.05). The use of levodopa was associated with less unsuccessful attempts at defecation (P < 0.05).
Most patients with PD only have minor constipation-related symptoms. However, severe constipation is associated with time since diagnosis and severity of disease.
帕金森病（PD）中肠道症状的临床重要性仍有待详细描述。
向468例PD患者发送了一份包含背景参数、克利夫兰便秘评分（CCS）以及神经源性肠功能障碍评分项目的33项问卷。将结果与对照组（CG）（n = 45）进行比较。CCS至少为15被用于定义严重便秘。
416名受试者（89%）做出了回应。PD患者的CSS中位数仅为4（范围0 - 21），CG组为2（范围0 - 13）（P < 0.05）。PD患者中7%有严重便秘，CG组为0%（P < 0.05）。PD患者排便不尽、需要辅助排便以及使用口服泻药的报告频率高于CG组（所有P < 0.05）。PD的严重程度与辅助排便（P < 0.001）、排便尝试失败（P < 0.001）、排便不尽（P < 0.05）以及CCS（P < 0.01）相关。诊断后的时间与排便不频繁（P < 0.0001）和CCS（P < 0.05）相关。左旋多巴的使用与排便尝试失败较少相关（P < 0.05）。
大多数PD患者仅有轻微的便秘相关症状。然而，严重便秘与诊断后的时间以及疾病严重程度相关。
