本文選題：帕金森病 + 臨床特征�。� 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：分析重慶市帕金森病患者的人口統(tǒng)計學(xué)特征及臨床特征,探討帕金森病運動癥狀、非運動癥狀、運動并發(fā)癥的危險因素,為指導(dǎo)帕金森病的早期診斷以及長期治療和全面管理方案的制定提供臨床依據(jù)。方法：連續(xù)收集我院門診及住院的帕金森病患者177名的人口學(xué)資料及臨床資料。對不同起病年齡、不同病程PD患者的臨床特征進行比較；分析H-Y分級與年齡、病程、LEDD等之間的關(guān)系；探討部分運動癥狀、非運動癥狀、運動并發(fā)癥的危險因素。結(jié)果：177例帕金森病患者(門診75例,住院部102例)中,男性占59.9%,平均年齡66.16±9.53歲,平均病程5.09±4.52年,平均身高體重指數(shù)(BMI)22.45±2.80kg/m2。平均起病年齡60.86±10.92歲,早發(fā)型(起病≤49歲)占16.4%。57.1%的患者以右側(cè)肢體起病,49.2%的患者以震顫為首發(fā)癥狀。平均改良H-Y分級為2.53±1.15級,且病程越長、LEDD值越高,H-Y分級越高。有36.2%的患者出現(xiàn)凍結(jié)步態(tài),12.4%的患者發(fā)生過跌倒。且H-Y分級越高,發(fā)生跌倒及凍結(jié)的風(fēng)險越高。52.5%的患者首選藥物為LD,而早發(fā)型患者中首選LD的患者占57.1%。LD治療的平均時間為3.45±4.10年,LEDD平均值為413.36±282.76mg。MAO-B抑制劑、COMT抑制劑類藥物的使用率非常低。還有9.6%的患者尚未服藥。組間比較顯示,PD發(fā)病年齡越小、病程越長,癥狀波動及異動癥的發(fā)生率越高。多因素分析顯示起病年齡50-69歲、H-Y分級3-5級、同時服用LD+DAs及LEDD≥400mg是癥狀波動的獨立危險因素,而起病年齡≤49歲、病程長、LEDD≥400mg是異動癥的獨立危險因素。神經(jīng)精神癥狀、自主神經(jīng)功能紊亂、感覺異常的發(fā)生率分別為85.9%、81.9%、74%。多因素分析提示,起病后LD延遲加入治療的時間越長,疼痛的發(fā)生率越高。結(jié)論：1、重慶市PD患者運動癥狀較重,非運動癥狀的發(fā)生率較高；2、重慶PD患者服用的抗帕金森病藥物結(jié)構(gòu)較單一,可能與患者經(jīng)濟狀況及醫(yī)療保險報銷范疇有關(guān)；3、早發(fā)型PD患者多數(shù)首選左旋多巴作為治療藥物,而少部分患者尚未予以抗帕金森病藥物治療,因此早發(fā)型和初診患者的治療有待進一步規(guī)范；4、需要重視以單側(cè)肢體乏力,伴或不伴運動遲緩為主要癥狀的門診患者,密切隨訪,這些患者有可能逐漸出現(xiàn)PD的核心癥狀；5、H-Y分級與病程、LEDD值呈正相關(guān)；6、起病年齡50-69歲、H-Y分級3-5級、同時服用LD+DAs及LEDD≥400mg是癥狀波動的獨立危險因素,而起病年齡≤49歲、病程長、LEDD≥400mg是異動癥的獨立危險因素;7、PD患者藥物治療方案的制定,需要綜合考慮患者的起病年齡、運動癥狀、非運動癥狀及運動并發(fā)癥等因素。
[Abstract]:Objective : To analyze the demographic characteristics and clinical characteristics of Parkinson ' s disease in Chongqing , to discuss the risk factors of Parkinson ' s disease ( Parkinson ' s disease ) , non - motor symptoms and motor complications , and to provide clinical basis for the early diagnosis of Parkinson ' s disease and the development of long - term treatment and comprehensive management . Methods : 177 patients with Parkinson ' s disease in our hospital and in hospital were collected continuously .
To analyze the relationship between H - Y classification and age , course , LEDD , etc .
Results : Among 177 patients with Parkinson ' s disease ( 75 patients , 102 in the inpatient department ) , 59.9 % of patients with Parkinson ' s disease ( n = 75 , 102 in the inpatient department ) , the average duration was 5.09 鹵 4.52 years , the higher the average body mass index ( BMI ) was 22.45 鹵 2.80kg / m2 .
2 . The drug structure of Parkinson ' s disease which is taken by PD patients in Chongqing is relatively single , which may be related to the economic situation of the patient and the reimbursement category of medical insurance .
3 . Most of the patients with early - onset PD were treated with left - dopa as a therapeutic drug , while some patients had yet to be treated with anti - Parkinson ' s disease , so the treatment of early - onset and early - onset patients was to be further standardized ;
4 . It is necessary to pay attention to outpatients with symptoms of unilateral limb fatigue , with or without exercise retardation , and follow - up closely , and these patients may gradually develop the core symptoms of PD ;
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本文編號：1859847