Dai Yan, Mao Chengjie, Ding Mengmeng, Ma Lijing, Fu Yunting, Zhang Huijun, Li Jie, Liu Chunfeng
Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2016 Feb 2;96(5):324-8. doi: 10.3760/cma.j.issn.0376-2491.2016.05.002.
To investigate the clinical characteristics of Parkinson's Disease (PD) patients with constipation and explore the correlation between constipation and motor symptoms.
The demographic data of outpatients with PD in our hospital was collected. According to Rome Ⅲ criteria, we evaluated the status of constipation in PD patients. Unified Parkinson's disease rating scale part Ⅲ (UPDRSⅢ), mini-mental state examination (MMSE) were performed in all the included patients.
Among the 158 recruited PD patients, 96 (60.8%) patients had constipation. Among these patients, 41(42.7%) patients experienced constipation before motor symptoms. Compared to those without constipation, PD patients with constipation had higher axial scores (6.8±3.4 vs 4.3±2.5, t=-4.887, P=0.000) and gait/postural stability scores (3.9±2.4 vs 2.4±1.5, t=-4.529, P=0.000), higher proportion of axial and gait/postural stability scores in UPDRSⅢ (32%±11% vs 25%±12%, t=-3.485, P=0.001; 18%±9% vs 15%±10%, t=-2.278, P=0.024), more rapid progression of axial and gait/postural stability symptoms (P<0.05). However, there were no differences in other sub-scores and progression of motor symptoms between the two groups (P>0.05). The PD patients with constipation preceding motor symptoms had higher proportion of axial and gait/postural stability scores in UPDRSⅢ (35%±11% vs 30%±10%, t=2.167, P=0.033; 21%±9% vs 16%±8%, t=2.733, P=0.008), indicating these patients may progress more rapidly, meanwhile, they had later onset age, shorter disease duration (P<0.05). Unconditioned Logistic regression showed that axial score was major influencing factor of constipation in PD patients (P=0.000, OR=1.330).
PD patients with constipation have severer axial symptoms, indicating the progression of these patients is relatively rapid, especially those with constipation preceding motor symptoms. It is suggested that axial symptoms and constipation are acted as interactional factors in PD.
探讨帕金森病（PD）便秘患者的临床特征，分析便秘与运动症状之间的相关性。
收集我院门诊PD患者的人口学资料，依据罗马Ⅲ标准评估PD患者便秘情况。对纳入研究的所有患者进行统一帕金森病评定量表第三部分（UPDRSⅢ）、简易精神状态检查表（MMSE）评定。
158例PD患者中，96例（60.8%）存在便秘。其中，41例（42.7%）患者在运动症状出现前已存在便秘。与无便秘的PD患者相比，便秘的PD患者轴性症状评分更高（6.8±3.4比4.3±2.5，t=-4.887，P=0.000）、步态/姿势稳定性评分更高（3.9±2.4比2.4±1.5，t=-4.529，P=0.000），UPDRSⅢ中轴性症状和步态/姿势稳定性评分比例更高（32%±11%比25%±12%，t=-3.485，P=0.001；18%±9%比15%±10%，t=-2.278，P=0.024），轴性症状和步态/姿势稳定性症状进展更快（P<0.05）。然而，两组间其他亚评分及运动症状进展无差异（P>0.05）。运动症状出现前已有便秘的PD患者UPDRSⅢ中轴性症状和步态/姿势稳定性评分比例更高（35%±11%比30%±10%，t=2.167，P=0.033；21%±9%比16%±8%，t=2.733，P=0.008），提示这些患者病情进展可能更快，同时其起病年龄较晚，病程较短（P<0.05）。非条件Logistic回归分析显示轴性症状评分是PD患者便秘的主要影响因素（P=0.000，OR=1.330）。
PD便秘患者轴性症状更严重，提示病情进展相对较快，尤其是运动症状出现前已有便秘者。提示轴性症状与便秘在PD中相互影响。
