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1、中华神经科杂志2003年12月第36卷第6期ChinJNeurol,December2003,Vol36,No.6·411··论著·帕金森病患者运动障碍和症状波动的影响因素刘春风尹伟华罗蔚峰【摘要】目的观察帕金森病患者运动障碍和症状波动发生情况,探讨两者发生的影响因素。方法对确诊的帕金森病患者进行随访,记录患者详细资料并进行UPDRS、H-Y分级、Schwab和英格兰日常生活量表评分,观察有无运动障碍和症状波动发生。对所得资料进行统计分析。结果63例帕金森病患者均接受左旋多巴治疗,观察发现11例(17.5%)出现运动
2、障碍,其中10例表现为肌张力障碍;36例(57.1%)出现症状波动,其中28例表现为剂末现象。左旋多巴平均日剂量(r=9.768,P=0.001)、UPDRS-off评分(r=0.076,P=0.008)与运动障碍呈正相关,左旋多巴治疗时间与症状波动呈正相关(r=0.738,P=0.002),控释剂的使用与其呈负相关(r=-3.378,P=0.015)。结论本组患者运动障碍的发生率较低,而症状波动的发生率与国外报道相近,左旋多巴平均日剂量和病情严重程度是运动障碍的主要影响因素,其治疗时间是症状波动的影响因素。运动综合
3、征主要表现为剂末现象和肌张力障碍。【关键词】帕金森病;左旋多巴;运动障碍FactorsofdyskinesiasandmotorfluctuationsinParkinson'sdiseaseLIUChun-feng,YINWei-hua,LUOWei-feng.DepartmentofNeurology,Second-AffiliatedHospitalofSuzhouUniversity,Suzhou215004,China【Abstract】ObjectiveToobservethedyskinesiasand
4、motorfluctuationinpatientswithParkin-son'sdisease,andinvestigatetheirinfluentialfactors.MethodsThedetailinformationofdyskinesiasandmotorfluctuationof63patientswithParkinson'sdiseasewererecordedandfollowedupwhentheofL-Dopatherapywascarriedout,andallpatientswerea
5、ssessedbyusingUPDRSat“on”and“off”stage,HoehnandYahrscale,SchwabandEnglandlivingscale.ThedatawerecalculatedwithSPSS10.0statisticsoftware.ResultsAllpatientsreceivedaloneorcombinedL-Dopatherapy.Amongthe63patients,11(17.5%)wereexperienceddyskinesias,inwhich10showdy
6、stonia;and36were(57.1%)experiencedmotorfluctuation,inwhich28developedwearing-off.ThemeandailydoseofL-dopaandscoreofUPDRSin“off”stagewerepositivelycorrelatedwithdyskinesias.ThedurationoftherapywithL-dopawaspositivelycorrelatedwithmotorfluctuation.Thecontrolledre
7、leasecabidopa/levodopawasinnegativecorrelation.ConclusionsTherateofmotorfluctuationwasapproximatelyequaltotheresultsreportedinothercountries.ThedyskinesiaswaslowerinoccurrenceandthemeandailydoseofL-dopaandthediseaseseverityshouldbethemaininfluencingfactorstothe
8、dyskinesias.ThedurationoftherapywithL-dopashouldbeinfluencingfactortomotorfluctuation.Themainsubtypeofmotorcomplicationsshouldbedystoniaandwearing-off.【Keywords】Parkinsondis
