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帕金森病患者中凸轮轴畸形的预测因素:来自中国西南部的前瞻性研究。

Predictors of camptocormia in patients with Parkinson's disease: A prospective study from southwest China.

机构信息

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Parkinsonism Relat Disord. 2018 Jul;52:69-75. doi: 10.1016/j.parkreldis.2018.03.020. Epub 2018 Mar 27.

Abstract

BACKGROUND

Camptocormia is becoming increasingly recognized as a prominent phenomenon in Parkinson's disease (PD).

OBJECTIVE

This study aims to investigate the clinical predictors of future camptocormia in a cohort of PD patients.

METHODS

A total of 263 PD patients without camptocormia were prospectively monitored for approximately 3 years. The end-point was the occurrence of camptocormia.

RESULTS

Overall, camptocormia was observed in 23 patients (8.7%) during the study period. The following variables including the proportion of males; age; disease duration; total levodopa equivalent daily dosage; Unified PD Rating Scale (UPDRS) III score; Hoehn and Yahr stage; the percentages of festination, freezing of gait and falls; and the subscores (e.g., "problems having sex") and frequencies (e.g., "forget to do things") of the Non-Motor Symptoms Scale were significantly higher in patients with camptocormia compared to those variables in patients without camptocormia (P < 0.05). Patients with camptocormia showed lower "orientation" subscore of the Montreal Cognitive Assessment scale than patients without camptocormia (P < 0.05). The binary logistic regression model indicated that the presence of camptocormia was associated with male sex (OR = 6.758, P = 0.001), a higher UPDRS III score (OR = 1.099, P = 0.001), a higher sexual dysfunction score (OR = 1.033, P = 0.038) and a lower orientation score (OR = 0.392, P = 0.018).

CONCLUSIONS

Camptocormia may emerge as PD progresses. Male patients and those with sexual dysfunction or disorientation are likely to present with camptocormia in the future.

摘要

背景

脊柱前屈在帕金森病(PD)中越来越被认为是一种突出的现象。

目的

本研究旨在调查 PD 患者队列中未来脊柱前屈的临床预测因素。

方法

共有 263 名无脊柱前屈的 PD 患者前瞻性监测了大约 3 年。终点是脊柱前屈的发生。

结果

研究期间,共有 23 名(8.7%)患者出现脊柱前屈。与无脊柱前屈的患者相比,出现脊柱前屈的患者中男性比例、年龄、疾病持续时间、左旋多巴等效日剂量、统一帕金森病评定量表(UPDRS)III 评分、Hoehn 和 Yahr 分期、出现慌张步态、冻结步态和跌倒的百分比以及非运动症状量表的子评分(如“性生活问题”)和频率(如“忘记做事”)更高(P < 0.05)。出现脊柱前屈的患者蒙特利尔认知评估量表的“定向”子评分低于无脊柱前屈的患者(P < 0.05)。二元逻辑回归模型表明,脊柱前屈的出现与男性(OR = 6.758,P = 0.001)、更高的 UPDRS III 评分(OR = 1.099,P = 0.001)、更高的性功能障碍评分(OR = 1.033,P = 0.038)和更低的定向评分(OR = 0.392,P = 0.018)有关。

结论

脊柱前屈可能随着 PD 的进展而出现。男性患者和有性功能障碍或定向障碍的患者将来可能会出现脊柱前屈。

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