Wang Yao, Shao Wei-bo, Gao Li, Lu Jie, Gu Hao, Sun Li-hua, Tan Yan, Zhang Ying-dong
Department of rehabilitation medicine, Nanjing Brain Hospital, Nanjing medical university, Nanjing, China.
Department of neurology, Renji Hospital, Shanghai Jiaotong University School of medicine, Shanghai, China.
PLoS One. 2014 Dec 29;9(12):e116123. doi: 10.1371/journal.pone.0116123. eCollection 2014.
There have been limited comparative data regarding the investigations on pulmonary and respiratory muscle function in the patients with different parkinsonism disorders such as Parkinson's disease (PD) and multiple system atrophy (MSA) versus normal elderly. The present study is aiming to characterize the performance of pulmonary function and respiratory muscle strength in PD and MSA, and to investigate the association with severity of motor symptoms and disease duration.
Pulmonary function and respiratory muscle strength tests were performed in 30 patients with PD, 27 with MSA as well as in 20 age-, sex-, height-, weight-matched normal elderly controls. All the patients underwent United Parkinson's disease rating scale (UPDRS) or united multiple system atrophy rating scale (UMSARS) separately as diagnosed.
Vital capacity, forced expiratory volume in 1 second and forced vital capacity decreased, residual volume and ratio of residual volume to total lung capacity increased in both PD and MSA groups compared to controls (p<0.05). Diffusing capacity was decreased in the MSA group, compared with PD and normal elderly control groups (p<0.05). Respiratory muscle strength was lower in both PD and MSA groups than in controls (p<0.05). The values representing spirometry function and respiratory muscle strength were found to have a negative linear correlation with mean score of UPDRS-III in PD and mean score of UMSARS-I in MSA. Respiratory muscle strength showed a negative linear correlation with the mean score of UMSARS-II and disease duration in MSA patients.
These findings suggest that respiratory dysfunction is involved in PD and MSA. Respiratory muscle strength is remarkably reduced, and some of the parameters correlate with disease duration and illness severity. The compromised respiratory function in neurodegenerative disorders should be the focus of further researches.
关于帕金森病（PD）和多系统萎缩（MSA）等不同帕金森综合征患者与正常老年人的肺和呼吸肌功能研究，比较数据有限。本研究旨在描述PD和MSA患者的肺功能和呼吸肌力量表现，并探讨其与运动症状严重程度和病程的关系。
对30例PD患者、27例MSA患者以及20名年龄、性别、身高、体重匹配的正常老年对照者进行肺功能和呼吸肌力量测试。所有患者在确诊后分别接受统一帕金森病评定量表（UPDRS）或统一多系统萎缩评定量表（UMSARS）评估。
与对照组相比，PD组和MSA组的肺活量、第1秒用力呼气量和用力肺活量均降低，残气量和残气量与肺总量之比增加（p<0.05）。与PD组和正常老年对照组相比，MSA组的弥散功能降低（p<0.05）。PD组和MSA组的呼吸肌力量均低于对照组（p<0.05）。发现代表肺量计功能和呼吸肌力量的值与PD组UPDRS-III的平均得分以及MSA组UMSARS-I的平均得分呈负线性相关。在MSA患者中，呼吸肌力量与UMSARS-II的平均得分和病程呈负线性相关。
这些发现表明呼吸功能障碍与PD和MSA有关。呼吸肌力量明显降低，且一些参数与病程和疾病严重程度相关。神经退行性疾病中受损的呼吸功能应成为进一步研究的重点。
