帕金森病患者合并糖尿病的非运动症状特征分析

发布时间：2018-04-06 21:08

本文选题：帕金森病　切入点：糖尿病　出处：《山东大学》2014年硕士论文

【摘要】：研究背景近年来,全球糖尿病的发病率迅速上升,临床上帕金森病合并糖尿病的患者越来越多见,糖尿病能够加重帕金森病患者的某些运动症状如肌强直和步态异常,国内外已有报道,但对于非运动症状的影响尚缺乏相关报道。目前随着帕金森病治疗理念的更新,除了改善运动症状,帕金森病患者的非运动症状正逐渐受到重视。研究目的本研究利用帕金森病非运动症状量表(NMSS)调查评估糖尿病对帕金森病非运动症状的影响,分析并总结合并糖尿病的帕金森病患者非运动症状的临床特点。研究方法一、研究对象连续收集于2013年2月至2014年1月在齐鲁医院神经内科门诊就诊的帕金森病患者200例,从中选出有糖尿病病史的患者30例及无糖尿病病史的患者30例,根据性别、帕金森病程(±1年)进行(1：1)配对研究。二、研究方法 (一)收集两组患者(60例)的基本资料,包括姓名、性别、年龄、病程、H-Y分级、药物剂量等。 (二)应用NMSS评估两组患者的非运动症状,每项非运动症状的分值为疾病严重程度(0分～3分)与发生频率(1分～4分)的乘积。为了研究非运动症状的发生率,把每项非运动症状划分为“是”或“否”两种状态,统计糖尿病组与对照组每项非运动症状的频数。三、统计分析应用SPSS17.0软件进行统计学分析。应用配对设计的符号秩和检验(Wilcoxon符号秩和检验)对糖尿病组患者和对照组患者人口统计学资料(性别、年龄、病程)进行分析。应用配对t检验对糖尿病组患者和对照组患者H-Y分级、美多巴等效剂量、非运动症状总分值进行比较；应用配对设计的符号秩和检验(Wilcoxon符号秩和检验)对糖尿病组患者和对照组患者每项非运动症状分值进行比较；应用卡方检验对糖尿病组患者和对照组患者非运动症状频数进行比较。所有的P值均为双侧P值,P0.05表示差异有统计学意义。研究结果一、糖尿病组患者H-Y分级平均为2.63±1.29级,对照组患者H-Y分级平均为2.40±0.86级,两组患者H-Y分级差异无统计学意义(p=0.152)。糖尿病组美多巴等效剂量平均值为(530.63±261.09)mg,对照组美多巴等效剂量平均值为(522.95±246.03)mg,两组患者美多巴等效剂量差异无统计学意义(p=0.632)。二、在糖尿病组,每位患者出现非运动症状数目的平均值是18.27±3.39,对照组为16.20±3.75,糖尿病组与对照组每位患者出现非运动症状的数目差异具有统计学意义(p=0.011)；与对照组相比,糖尿病组患者非运动症状数目多12.8%。在糖尿病组,每位患者的非运动症状总分值的平均值是97.00±31.39,对照组为91.73±40.33,糖尿病组与对照组每位患者出现的非运动症状总分值差异无统计学意义(p=0.438)。糖尿病组与对照组比较,各项非运动症状频数差异具有统计学意义的是嗜睡(p=0.011)以及知觉与幻觉(p=0.037)和胃肠道症状(p=0.024)；糖尿病组与对照组比较,每项非运动症状分值差异具有统计学意义的是嗜睡(p=0.001)、情绪低落(p=0.016)及性功能改变(p=0.011)。结论糖尿病可以增加帕金森病患者非运动症的数目,总体上,合并糖尿病的原发性帕金森病患者比无糖尿病的患者表现出更多的非运动症状。合并糖尿病的原发性帕金森病患者嗜睡、知觉与幻觉及胃肠道症状的发生率明显高于无糖尿病的患者。糖尿病对帕金森病患者非运动症状总体的严重程度无明显影响,但合并糖尿病的原发性帕金森病患者个别非运动症状如嗜睡、情绪低落及性功能改变较无糖尿病的患者表现明显严重。
[Abstract]:Background of the study

In recent years , the incidence of diabetes in the world has been rising rapidly , and more and more patients with Parkinson ' s disease complicated with diabetes are more and more frequently seen .

Objective To investigate the effect of diabetes on non - motor symptoms of Parkinson ' s disease ( Parkinson ' s disease ) and to summarize the clinical features of non - exercise symptoms in patients with Parkinson ' s disease .

Research Methods

I . Study Object

A total of 200 patients with Parkinson ' s disease were continuously collected from February 2013 to January 2014 in the Department of Neuroendocrine in Qu Hospital . 30 patients with history of diabetes and 30 patients with no history of diabetes were selected . According to sex , Parkinson ' s disease ( 卤 1 year ) was carried out ( 1 : 1 ) .

II . Research Methodology

( 1 ) The basic data of two groups ( 60 cases ) were collected , including name , sex , age , course , H - Y grade , drug dose , etc .

( 2 ) Using NMSS to evaluate the non - motor symptoms of the two groups , the score of each non - sports symptom was the product of the severity of disease ( 0 - 3 ) and the frequency ( 1 - 4 ) . To study the incidence of non - motor symptoms , each non - motor symptom was divided into " yes " or " No " , and the frequency of each non - exercise symptom in the diabetic group and the control group was statistically analyzed .

III . Statistical Analysis

Statistical analysis was carried out by SPSS 17.0 software . The statistical data ( sex , age , duration ) of the patients with diabetes and the control group were analyzed by using the paired t test ( Wilcoxon signed rank sum test ) .
The non - exercise symptom scores were compared between the diabetic group and the control group by the sign rank sum test ( Wilcoxon signed rank sum test ) of the paired design ;
The frequency of non - exercise symptoms in the diabetic group and the control group were compared by using the Chi - square test . All the P values were bilateral p - values , and the difference was statistically significant .

Results of the study

The mean values of H - Y in diabetic group were 2.63 卤 1.29 and 2.40 卤 0.86 respectively in the control group . The mean value of MDOPA in diabetic group was ( 530.63 卤 269.09 ) mg and ( 529.95 卤 246.03 ) mg in control group . There was no significant difference between the two groups ( p = 0.632 ) .

2 . In the diabetes group , the mean value of the number of non - sports symptoms in each patient was 18.27 卤 3.39 , the control group was 16.20 卤 3.75 , and the number of non - motor symptoms in the diabetic group and the control group was statistically significant ( p = 0 . 011 ) ;
Compared with the control group , the number of non - exercise symptoms in the diabetic group was more than 12.8 % . In the diabetic group , the mean value of the total score of non - exercise symptoms was 97.00 卤 31.39 in each patient , 91.73 卤 40.33 in the control group , and there was no significant difference in the total score of non - exercise symptoms in the diabetic group and the control group ( p = 0 . 011 ) , and that of consciousness and illusion ( p = 0.037 ) and gastrointestinal symptoms ( p = 0 . 024 ) .
Compared with the control group , the difference of score of each non - exercise symptom score was statistically significant ( p = 0.001 ) , depression ( p = 0 . 016 ) and sexual function change ( p = 0 . 011 ) .

Conclusion

Diabetes mellitus can increase the number of non - exercise symptoms in patients with Parkinson ' s disease . In general , patients with primary Parkinson ' s disease combined with diabetes show more non - exercise symptoms than those without diabetes . Patients with primary Parkinson ' s disease combined with diabetes have a significantly higher incidence of non - exercise symptoms in patients with Parkinson ' s disease .

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.5;R587.1

【参考文献】