帕金森病运动并发症的临床调查分析

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1、分类号：R742.5密级：公开帕金森病运动并发症的临床调查分析MotorcomplicationsinpatientswithParkinson’sdisease作者姓名：王琼学科专业：神经病学导师：王振福教授答辩委员会主席：论文答辩日期：二〇一三年五月三十日院校地址：北京市复兴路28号邮政编码：100853解放军学院研究生学位论文原创性声明秉承我院“忠诚、敬业、和谐、创新”的学风，本人声明：所呈交的论文是我本人在导师指导下进行的研究工作及取得的研究成果。据我所知，除了文中特别加以标注和致谢的地方外，论文中不包含任何其他个人或集体已经发表或撰写过的研究成果，也不含为获

2、得我院或其他教育机构的学位及证书而使用过的材料，对本文的研究作出贡献的个人或集体，均已在文中做了明确的说明并表示谢意。申请学位论文与资料若有不实之处，本人承担一切相关责任。论文作者签名：指导教师签名：日期：日期：解放军医学院研究生学位论文版权使用授权书本人保证毕业离院后，发表论文或使用论文工作成果时署名单位为解放军医学院或解放军总医院。学院有权保留并向国家有关部门或机构送交论文原件、复印件和电子版本，可以采用影印、缩印、扫描或其它手段保存论文以供被查阅和借阅。学院可以公布学位论文的全部或部分内容（保密内容除外）。论文作者签名：指导教师签名：日期：日期：目录中文摘要„„„

3、„„„„„„„„„„„„„„„„„„„„„„„2英文摘要„„„„„„„„„„„„„„„„„„„„„„„„„„4前言„„„„„„„„„„„„„„„„„„„„„„„„„„„„6正文„„„„„„„„„„„„„„„„„„„„„„„„„„„„81.对象与方法„„„„„„„„„„„„„„„„„„„„„„„„82.结果„„„„„„„„„„„„„„„„„„„„„„„„„„„133.讨论„„„„„„„„„„„„„„„„„„„„„„„„„„„174.结论„„„„„„„„„„„„„„„„„„„„„„„„„„„23参考文献„„„„„„„„„„„„„„„„„„„„„„„„„„24文献综述„„„„„„

4、„„„„„„„„„„„„„„„„„„„„31附录„„„„„„„„„„„„„„„„„„„„„„„„„„„„43攻读学位期间发表文章情况„„„„„„„„„„„„„„„„„„48致谢„„„„„„„„„„„„„„„„„„„„„„„„„„„„49解放军医学院硕士学位论文英文缩略词语表英文缩写PDWOQ-9mAIMSUPDRSH-YLDLDRCOMTMPTPPET5-HTNMDADBS英文全称Parkinson’sdisease9-itemWearing-offquestionnaireModifiedabnormalinvoluntarymovementscaleUnifiedPa

5、rkinson’sdiseaseratingscaleHoehn-YahrstagingLevodopaLong-durationresponseCatechol-O-methyltransferase1-methyl-4-phenyl-1,2,3,6-tetrahydropyridinePositronemissiontomography5-hydroxytryptamineN-methyl-D-asparticacidDeepbrainstimulation1中文全称帕金森病剂末现象-9项问卷改良版不自主运动评定量表统一帕金森病评定量表H-Y分级左旋多巴长时程反应儿茶

6、酚-氧位-甲基转移酶1-甲基-4-苯基-1,2,3,6-四氢吡啶正电子发射计算机断层扫描5-羟色胺N-甲基-D-天冬氨酸深部脑刺激解放军医学院硕士学位论文作者：王琼学科专业：神经病学导师：王振福帕金森病运动并发症的临床调查分析中文摘要左旋多巴制剂一直是治疗帕金森病（Parkinson’sdisease，PD）最有效药物，但当经过一段时间“蜜月期”治疗后经常会出现运动并发症，严重的运动并发症对患者的生活质量造成很大影响。本研究目的是观察帕金森病患者运动并发症的发生率及其影响因素，为运动并发症的预防提供帮助。通过对PD患者的调查，记录患者一般情况，包括性别，年龄，教育程度，

7、吸烟史，高血压及糖尿病病史；记录PD患者起病年龄，病程，首发症状，起始治疗药物，服用抗帕金森药物类型、剂型、单次服药剂量、用药频次、服药时间及药物疗程；对于服用左旋多巴制剂的≥30天的患者进行WOQ-9问卷调查，未服用左旋多巴制剂的PD患者或者左旋多巴制剂服用时间＜30天的患者不进行WOQ-9调查，WOQ-9发现存在剂末现象的患者经过医师进一步判断患者的剂末现象；对所有患者进行统一帕金森病评定量表第3部分（UPDRSⅢ）、H-Y分级、mAIMS量表评估。使用SPSS13.0对结果进行统计分析。研究共纳入116例PD