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治疗和未治疗的中国早期帕金森病患者的非运动症状。

Non-motor symptoms in treated and untreated Chinese patients with early Parkinson's disease.

机构信息

Department of Neurobiology and Neurology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University.

出版信息

Tohoku J Exp Med. 2014 Feb;232(2):129-36. doi: 10.1620/tjem.232.129.

Abstract

Non-motor symptoms (NMS) are important preclinical features of Parkinson's disease (PD) and have become the leading cause of poor quality of life with disease progression. There are little data on how antiparkinsonian medications influence the NMS in PD at early stage. In this study, we explored the distribution of NMS in treated and untreated PD and investigated the association between NMS and antiparkinsonian medications in Chinese patients with early PD. Subjects were enrolled from a Chinese PD patient cohort based on 2 clinical trials. Face-to-face interviews and evaluations were performed for clinical information. NMS were compared in patients with or without antiparkinsonian treatment, and between subgroups of dopaminergic medications. Eight hundred and sixteen PD patients were enrolled in this study, of whom 428 were newly diagnosed PD. Only 5 in 646 patients who completed all these NMS measurements (0.6%) were free of NMS. PD patients with antiparkinsonian medications had a significantly higher frequency of poor sleep (p = 0.001), depression (p = 0.0001) and constipation (p = 0.0001) after adjusted gender, onset age, duration, and Hoehn & Yahr stage. Moreover, patients treated by levodopa plus dopamine agonist had a higher percentage of bad sleepers (adjusted p = 0.040), and correlation analysis revealed that Levodopa Equivalent Dose (LED) was associated with constipation (coefficient 0.146, p = 0.005). These findings suggest that although NMS exist in the prodromal stage of PD, antiparkinsonian treatment is associated with increased frequency of some NMS, which may challenge the management for PD.

摘要

非运动症状(NMS)是帕金森病(PD)的重要临床前特征,并且随着疾病的进展,已成为导致生活质量下降的主要原因。关于抗帕金森病药物如何影响早期 PD 患者的 NMS,数据甚少。在这项研究中,我们探讨了治疗和未治疗的 PD 患者中 NMS 的分布,并研究了中国早期 PD 患者 NMS 与抗帕金森病药物之间的关系。该研究的受试者是根据两项临床试验从中国 PD 患者队列中招募的。通过面对面访谈和评估来获取临床信息。比较了有或没有抗帕金森病治疗的患者以及不同多巴胺能药物亚组之间的 NMS。本研究共纳入 816 名 PD 患者,其中 428 名患者为新诊断的 PD。在完成所有这些 NMS 测量的 646 名患者中,仅有 5 名(0.6%)患者无 NMS。接受抗帕金森病药物治疗的 PD 患者睡眠质量差(p = 0.001)、抑郁(p = 0.0001)和便秘(p = 0.0001)的频率明显更高,调整性别、发病年龄、病程和 Hoehn & Yahr 分期后,差异仍然具有统计学意义。此外,接受左旋多巴加多巴胺激动剂治疗的患者中,睡眠质量差的患者比例更高(调整后的 p = 0.040),相关性分析表明,左旋多巴等效剂量(LED)与便秘相关(系数 0.146,p = 0.005)。这些发现表明,尽管 NMS 存在于 PD 的前驱期,但抗帕金森病治疗与某些 NMS 发生率的增加有关,这可能会对 PD 的管理提出挑战。

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