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初发帕金森病患者非运动症状及生活质量的性别与发病年龄相关差异

Gender and onset age related-differences of non-motor symptoms and quality of life in drug-naïve Parkinson's disease.

作者信息

Hu Tao, Ou Ruwei, Liu Hui, Hou Yanbing, Wei Qianqian, Song Wei, Cao Bei, Chen Yongping, Yuan Xiaoqin, Shang Huifang

机构信息

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

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

出版信息

Clin Neurol Neurosurg. 2018 Dec;175:124-129. doi: 10.1016/j.clineuro.2018.11.001. Epub 2018 Nov 2.

Abstract

OBJECTIVE

This study aims to explore the gender and onset age-related differences of non-motor symptoms (NMS) and the determinants of quality of life (QoL) in a large cohort of Chinese drug-naïve Parkinson's disease (PD) patients.

PATIENTS AND METHODS

A cross-sectional analysis of 569 drug-naïve PD patients was conducted. The frequency and severity of each NMS was evaluated by Non-Motor Symptom Scale (NMSS), which consists of 9 subdomains. PD Questionnaire-39 (PDQ-39) was used to assess the QoL of PD patients. A stepwise multiple regression model was used to explore the determinants of QoL.

RESULTS

A total of 552 patients (97.0%) exhibited at least one NMS. The three most common NMS were sleep/fatigue (74%), attention/memory (62.7%) and miscellaneous (62%). The frequencies of sleep/fatigue and mood/apathy were more prevalent in women and the frequencies of urinary and sexual dysfunction were more prevalent in men (P < 0.05). Patients with late-onset PD showed higher frequencies of perceptual problems/hallucinations, attention/memory, gastrointestinal, urinary, sexual dysfunction, and miscellaneous compared to patients with early-onset PD (P < 0.05). The multiple regression analysis model indicated that female, disease duration, UPDRS III score, depression, and NMSS subcores including sleep/fatigue, mood/apathy, attention/memory, and gastrointestinal were the determinants of QoL in patients with drug-naïve PD.

CONCLUSIONS

NMS was common in untreated PD patients. They are heterogeneous in patients with drug-naïve PD, which are dramatic determinants on decreased QoL in PD. Our results are beneficial for clinical management of NMS in drug-naïve PD.

摘要

目的

本研究旨在探讨一大群未服用过药物的中国帕金森病(PD)患者非运动症状(NMS)的性别和发病年龄相关差异以及生活质量(QoL)的决定因素。

患者与方法

对569例未服用过药物的PD患者进行横断面分析。通过由9个亚领域组成的非运动症状量表(NMSS)评估每种NMS的频率和严重程度。使用帕金森病问卷-39(PDQ-39)评估PD患者的生活质量。采用逐步多元回归模型探讨生活质量的决定因素。

结果

共有552例患者(97.0%)表现出至少一种NMS。三种最常见的NMS是睡眠/疲劳(74%)、注意力/记忆力(62.7%)和其他(62%)。睡眠/疲劳和情绪/淡漠的发生率在女性中更高,而泌尿和性功能障碍的发生率在男性中更高(P < 0.05)。与早发型PD患者相比,晚发型PD患者的感知问题/幻觉、注意力/记忆力、胃肠道、泌尿、性功能障碍及其他方面的发生率更高(P < 0.05)。多元回归分析模型表明,女性、病程、统一帕金森病评定量表第三部分(UPDRS III)评分、抑郁以及包括睡眠/疲劳、情绪/淡漠、注意力/记忆力和胃肠道在内的NMSS子核心是未服用过药物的PD患者生活质量的决定因素。

结论

NMS在未治疗的PD患者中很常见。在未服用过药物的PD患者中它们具有异质性,是PD患者生活质量下降的重要决定因素。我们的结果有助于未服用过药物的PD患者NMS的临床管理。

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