帕金森病患者幻觉相关因素研究

发布时间：2018-02-28 13:30

本文关键词： 帕金森病幻觉泌尿系统症状焦虑　出处：《中国实用内科杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探究幻觉在帕金森病(PD)患者中的发生率及其临床相关因素。方法连续纳入2013年6月到2016年11月四川大学华西医院神经内科就诊的PD患者518例。收集详细的临床资料,并进行一系列量表评估,包括统一帕金森病评估量表(UPDRS)、帕金森病生活质量问卷-39(PDQ-39)、非运动症状评估量表(NMSS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、额叶功能评估量表(FAB)及蒙特利尔认知功能评估量表(MoCA)。将患者分成幻觉组和非幻觉组,比较两组患者的人口统计学资料、临床资料及各个量表的评分并进行多因素分析。结果 49例(9.5%)PD患者出现幻觉症状;幻觉组患者的年龄、病程、左旋多巴等效日剂量、多巴胺受体激动剂的使用率、UPDRS运动评分、HY分级及症状波动和异动症的发生率均显著高于非幻觉组(P0.05);而校正相关混杂因素后,幻觉组患者的NMSS总分及各亚项评分、HAMD总分、HAMA总分及PDQ-39总分均显著高于非幻觉组(P0.05),但两组FAB总分和MoCA总分差异无统计学意义;向前的二元Logistic回归模型显示,病程(OR=1.142,P0.001)、NMSS量表中的泌尿系统症状评分(OR=1.058,P=0.001)及HAMA评分(OR=1.058,P=0.009)与PD患者幻觉的发生有关。结论 PD患者出现幻觉并不少见,其出现可能会降低患者生活质量;病程较长的PD患者更容易出现幻觉;PD患者出现幻觉与运动症状无关,可能与某些非运动症状(如泌尿系统症状及焦虑)有关。
[Abstract]:Objective to investigate the incidence of hallucination in patients with Parkinson's disease (PD) and its clinical related factors. Methods 518 PD patients who were admitted to Department of Neurology, Huaxi Hospital, Sichuan University from June 2013 to November 2016, were enrolled and their clinical data were collected. And a series of scales were evaluated, They include the Unified Parkinson's Disease Assessment scale, the Parkinson's Disease quality of Life questionnaire -39, the Non-motor symptom Assessment scale, the Hamilton Depression scale, the Hamilton anxiety scale, the frontal lobe function Assessment scale, and the Montreal Cognitive function scale. The patients were divided into hallucination group and non-hallucinatory group. The demographic data, clinical data and scores of each scale were compared and multivariate analysis was carried out between the two groups. Results the hallucination symptoms were found in 49 patients with 9. 5 PD, the age, course of disease, the equivalent daily dose of levodopa in the hallucination group, the age of the patients, the course of disease, and the equivalent daily dose of levodopa. The utilization rate of dopamine receptor agonists and the incidence of symptoms fluctuation and dyskinesia were significantly higher in UPDRS motor score and HY grade than in non-hallucinogenic group (P 0.05), and after adjusting for the associated confounding factors, The total scores of NMSS, Hamd, Hama and PDQ-39 in hallucination group were significantly higher than those in non-hallucination group (P 0.05), but there was no significant difference in total FAB score and MoCA total score between the two groups. The urinary system symptom score of OR1. 058 / P0. 001) and the HAMA score of OR1. 058 / P0. 009) were associated with the occurrence of hallucination in PD patients. Conclusion the occurrence of hallucinations in PD patients is not uncommon and may decrease the quality of life of the patients. PD patients with longer course of disease are more prone to hallucination. The hallucinations of PD patients are not related to motor symptoms, but may be related to some non-motor symptoms (such as urinary system symptoms and anxiety).
【作者单位】：四川大学华西医院神经内科;
【基金】：国家自然科学基金(81571247)
【分类号】：R742.5

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