帕金森病和多系统萎缩-帕金森综合征中的泌尿生殖系统症状：发病时及之后。
Urogenital symptoms in Parkinson's disease and multiple system atrophy-Parkinsonism: at onset and later.
作者信息
Swaminath Pazhayannur V, Ragothaman Mona, Koshy Suma, Sarangmath Nagaraja, Adhyam Mohan, Subbakrishna D K, Mathias Christopher J, Muthane Uday B
机构信息
Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
出版信息
J Assoc Physicians India. 2010 Feb;58:86-90.
METHODS
One hundred and eighty-one parkinsonian patients were evaluated to determine if urogenital symptoms at presentation to the Neurology clinic can differentiate them as PD or MSA-P. An autonomic questionnaire was used to document urinary and genital symptoms.
RESULTS
Mean age at presentation and disease duration in PD and MSA-P were similar. Urinary symptoms occurred twice as frequently in MSA-P than in PD. Storage symptoms (frequency, urgency, urge incontinence, nocturia) were common in both Parkinsonian disorders. Male MSA-P reported genital symptoms (erectile and ejaculatory failure) three times more frequently than in PD.
CONCLUSIONS
Urogenital symptoms occurred in MSA-P when they had mild motor few symptoms unlike in PD where they occur when motor symptoms were severe. Urogenital dysfunction occurred early and was present in all MSA-P patients within two years. Presence of urogenital symptoms in early stages of Parkinsonism strongly favors MSA-P rather than PD. Absence of urogenital symptoms in advanced Parkinsonism makes MSA-P unlikely.
方法
对181例帕金森病患者进行评估，以确定在神经科门诊就诊时的泌尿生殖系统症状是否能将他们区分为帕金森病（PD）或多系统萎缩帕金森综合征型（MSA-P）。使用一份自主神经问卷记录泌尿和生殖系统症状。
结果
PD和MSA-P患者就诊时的平均年龄和病程相似。MSA-P患者出现泌尿症状的频率是PD患者的两倍。储尿症状（尿频、尿急、急迫性尿失禁、夜尿症）在这两种帕金森病中都很常见。男性MSA-P患者报告生殖系统症状（勃起功能障碍和射精功能障碍）的频率是PD患者的三倍。
结论
与PD患者在运动症状严重时才出现泌尿生殖系统症状不同，MSA-P患者在运动症状轻微时就出现了泌尿生殖系统症状。泌尿生殖系统功能障碍出现得早，且在所有MSA-P患者中两年内都会出现。帕金森病早期出现泌尿生殖系统症状强烈提示为MSA-P而非PD。帕金森病晚期无泌尿生殖系统症状则不太可能是MSA-P。
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