西宁地区不同类型帕金森病患者影响因素分析

发布时间：2018-11-15 18:21

【摘要】：目的探讨西宁地区帕金森病(PD)不同临床类型组成及其影响因素。方法采取回顾性研究方法,收集2011年8月—2016年8月在青海省人民医院住院的青海省西宁地区(平均海拔2,260米)居住的居民PD患者631例,以震颤型,混合型和僵直型三种临床分型收集病历资料并进行数据分析。采取病例对照研究方法,收集2015年8月—2016年8月在青海省人民医院神经内科门诊收集46例PD患者,同时收集年龄、性别与PD组相匹配的对照组46例,采用化学发光法测定血清内总25(OH)维生素D、同型半胱氨酸、叶酸和维生素B12浓度水平,采用MEDIX90双能X线骨密度测量仪进行骨密度检测。结果1.西宁地区PD患者631例中,震颤型284例(45.0%)、强直型161例(25.5%)、混合型186例(29.5%)。2.PD三种临床分型中,性别、吸烟史、工作性质、服用药物、多汗、发病年龄、病程、尿酸、低密度脂蛋白差异有统计学意义(P0.05);年龄、民族、饮酒史、睡眠、便秘、流涎、焦虑、抑郁、痴呆、血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、同型半胱氨酸的比较,差异无统计学意义(P0.05)。3.三种临床分型中,与混合型相比,尿酸、脑力劳动是僵直型危险因素(OR值=1.003,95%CI:1.000-1.005;OR值=2.557,95%CI:1.160-5.636)。与僵直型相比,低密度脂蛋白是震颤型保护因素(OR值=0.747,95%CI:0.578-0.996)。4.与对照组比较,PD组维生素D、叶酸、骨密度值均明显降低,差异具有统计学意义(P0.05)。结论西宁地区帕金森病患者三种临床分型以震颤型所占比例最高,其次是混合型,最少为僵直型。血尿酸和脑力劳动是僵直型危险因素,低密度脂蛋白是震颤型保护因素。中高海拔地区帕金森病患者血清25-羟维生素D、叶酸浓度和骨密度PD均低于健康者。
[Abstract]:Objective to investigate the clinical types and influencing factors of Parkinson's disease (PD) in Xining area. Methods A retrospective study was conducted to collect 631 PD patients who were hospitalized in Qinghai Provincial people's Hospital from August 2011 to August 2016, with an average altitude of 2260 meters. Three clinical types of mixed type and stiff type were collected and analyzed. A case-control study was conducted to collect 46 patients with PD from August 2015 to August 2016 in Department of Neurology, Qinghai Provincial people's Hospital, and 46 cases of control group matched by age, sex and PD group. The concentrations of total 25 (OH) vitamin D, homocysteine, folic acid and vitamin B12 in serum were determined by chemiluminescence method. Bone mineral density (BMD) was measured by MEDIX90 dual energy X-ray absorptiometry. Result 1. Of the 631 patients with PD in Xining area, 284 (45.0%) were tremor type, 161 (25.5%) were ankylosis type and 186 (29.5%) were mixed type. There were significant differences in hyperhidrosis, age of onset, course of disease, uric acid and low density lipoprotein (P0.05). Age, nationality, drinking history, sleep, constipation, salivation, anxiety, depression, dementia, hemoglobin, cholesterol, triglyceride, high density lipoprotein, homocysteine were not significantly different (P0.05). Compared with the mixed type, uric acid and mental labor were the risk factors of rigidity (OR = 1.003 ~ 95 CI: 1.000-1.005 OR = 2.55795 CI: 1.160-5.636). Low density lipoprotein (LDL) is a protective factor for tremor (OR = 0.7477.95 CI: 0.578-0.996) compared with stiff type. 4. Compared with the control group, PD group vitamin D, folic acid, bone mineral density values were significantly decreased, the difference was statistically significant (P0.05). Conclusion the three clinical types of Parkinson's disease in Xining area are tremor type, mixed type and inflexible type. Serum uric acid and mental labor were risk factors for stiffness and low density lipoprotein (LDL) was a protective factor for tremor. Serum 25-hydroxyvitamin D, folic acid concentration and bone mineral density (PD) in Parkinson's disease patients were lower than those in healthy subjects.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5

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