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早期特发性帕金森病患者呼吸中枢驱动(P0.1)和肌肉力量的失调

Dysregulation of Respiratory Center Drive (P0.1) and Muscle Strength in Patients With Early Stage Idiopathic Parkinson's Disease.

作者信息

Zhang Wei, Zhang Lei, Zhou Ning, Huang Enqiang, Li Qi, Wang Tongyu, Ma Chunchao, Li Bin, Li Chen, Du Yanfen, Zhang Jing, Lei Xiaofeng, Ross Alysia, Sun Hongyu, Zhu Xiaodong

机构信息

Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.

Department of Respiratory, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Front Neurol. 2019 Jul 3;10:724. doi: 10.3389/fneur.2019.00724. eCollection 2019.

Abstract

The goal of this study is to evaluate pulmonary function and respiratory center drive in patients with early-stage idiopathic Parkinson's disease (IPD) to facilitate early diagnosis of Parkinson's Disease (PD). 43 IPD patients (Hoehn and Yahr scale of 1) and 41 matched healthy individuals (e.g., age, sex, height, weight, BMI) were enrolled in this study. Motor status was evaluated using the Movement Disorders Society-Unified PD Rating Scale (MDS-UPDRS). Pulmonary function and respiratory center drive were measured using pulmonary function tests (PFT). All IPD patients were also subjected to a series of neuropsychological tests, including Non-Motor Symptoms Questionnaire (NMSQ), REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Beck Depression Inventory (BDI) and Mini Mental State Examination (MMSE). IPD patients and healthy individuals have similar forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), forced expiratory volume in 1s/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and carbon monoxide diffusion capacity (DLCOcSB). Reduced respiratory muscle strength, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) was seen in IPD patients ( = 0.000 and = 0.002, respectively). Importantly, the airway occlusion pressure after 0.1 s (P0.1) and respiratory center output were notably higher in IPD patients ( = 0.000) with a remarkable separation of measured values compared to healthy controls. Our findings suggest that abnormal pulmonary function is present in early stage IPD patients as evidenced by significant changes in PImax, PEmax, and P0.1. Most importantly, P0.1 may have the potential to assist with the identification of IPD in the early stage.

摘要

本研究的目的是评估早期特发性帕金森病(IPD)患者的肺功能和呼吸中枢驱动,以促进帕金森病(PD)的早期诊断。本研究纳入了43例IPD患者(Hoehn和Yahr分级为1级)和41例匹配的健康个体(如年龄、性别、身高、体重、BMI)。使用运动障碍协会统一PD评定量表(MDS-UPDRS)评估运动状态。使用肺功能测试(PFT)测量肺功能和呼吸中枢驱动。所有IPD患者还接受了一系列神经心理学测试,包括非运动症状问卷(NMSQ)、快速眼动睡眠行为障碍筛查问卷(RBDSQ)、贝克抑郁量表(BDI)和简易精神状态检查(MMSE)。IPD患者和健康个体的用力肺活量(FVC)、第1秒用力呼气量(FEV1)、第1秒用力呼气量/用力肺活量(FEV1/FVC)、呼气峰值流速(PEF)和一氧化碳弥散量(DLCOcSB)相似。IPD患者的呼吸肌力量、最大吸气压力(PImax)和最大呼气压力(PEmax)降低(分别为P = 0.000和P = 0.002)。重要的是,与健康对照组相比,IPD患者在0.1秒后的气道闭塞压(P0.1)和呼吸中枢输出显著更高(P = 0.000),测量值有明显差异。我们的研究结果表明,早期IPD患者存在肺功能异常,表现为PImax、PEmax和P0.1的显著变化。最重要的是,P0.1可能有潜力协助早期识别IPD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cd2/6618698/c51a58cf7b68/fneur-10-00724-g0001.jpg

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