脑白质病变与帕金森病患者运动症状及非运动症状的相关性分析

王伟; 曹庆华; 孙光玲; 苏杭

doi:10.16766/j.cnki.issn.1674-4152.002321

脑白质病变与帕金森病患者运动症状及非运动症状的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.002321

宁波大学医学院附属医院脑科中心，浙江宁波 315020

基金项目:

浙江省医药卫生科技计划项目 2020KY875

详细信息

通讯作者:
王伟, E-mail: wangzhiqqe@126.com

中图分类号: R742.5 R743
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- 文章访问数: 384
- HTML全文浏览量: 500
- PDF下载量: 14
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-17
- 网络出版日期: 2022-03-04

Correlation analysis of white matter lesions and motor symptoms and non-motor symptoms in Parkinson's patients

Brain Center, the Affiliated Hospital of Medical School, NingBo University, NingBo, Zhejiang 315020, China

摘要

摘要: 目的探讨脑白质病变(WML)对帕金森病(PD)患者运动症状及非运动症状的影响。方法选择宁波大学医学院附属医院2017年5月—2020年4月原发性PD患者148例并根据是否伴有WML分为WML组83例、非WML组65例，根据Fazekas评分分为WML0级组65例、1级组25例、2级组30例、3级组28例。比较WML组与非WML组一般资料、不同WML分级组PD评分量表Ⅲ(UPDRS Ⅲ)、PD非运动症状问卷(NMSQ)，以logistic回归分析WML与PD患者运动症状、非运动症状的关系。结果 WML组UPDRS Ⅲ评分为(25.52±4.24)分，高于非WML组(18.65±4.12)分(t=9.905，P＜0.05)，运动障碍程度较非WML组更严重(χ²=50.776，P＜0.05)。非WML组NMSQ评分(12.65±1.32)分，WML组NMSQ评分(17.25±3.12)分，WML组NMSQ评分高于非WML组(t=11.126，P＜0.05)。多因素回归分析结果显示，UPDRS Ⅲ评分越高、H&Y分期重度比例越高及NMSQ评分越高均为PD患者WML重度分期的危险因素(P＜0.05)。结论 WML会增加PD运动症状及非运动症状，且风险程度与WML分级相关。
- 帕金森病 /
- 脑白质病变 /
- 运动症状 /
- 非运动症状 /
- 相关性
Abstract: Objective To investigate the effect of white matter lesion (WML) on motor and non-motor symptoms in patients with Parkinson disease (PD). Methods Total 148 patients with primary PD from the Affiliated Hospital of Ningbo University School of Medicine from May 2017 to April 2020 were selected and divided into WML group (83 cases) and non-WML group (65 cases) according to whether they were accompanied by WM. According to Fazekas score, there were 65 cases in WML 0 group, 25 cases in grade 1 group, 30 cases in grade 2 group and 28 cases in grade 3 group. The general data of WML group and non-WML group, PD score scale Ⅲ (UPDRS Ⅲ) and PD non-motor symptom questionnaire (NMSQ) of different WML grading groups were compared, and the relationship between WML and PD patients with motor symptoms and non-motor symptoms was analyzed by Logistic regression. Results The UPDRS Ⅲ score of the WML group was (25.52±4.24) points, which was higher than the (18.65±4.12) points of the non-WML group (t=9.905, P < 0.05), and the degree of dyskinesia was more serious than that of the non-WML group (χ²=50.776, P < 0.05). The NMSQ score of the non-WML group was (12.65±1.32) points, the NMSQ score of the WML group was (17.25±3.12) points, and the NMSQ score of the WML group was higher than that of the non-WML group (t=11.126, P < 0.05). The results of multivariate regression analysis showed that the higher the UPDRS Ⅲ score, the higher the proportion of severe H &Y staging, and the higher the NMSQ score were all risk factors for PD patients with severe WML staging (P < 0.05). Conclusion WML can increase PD motor symptoms and non-motor symptoms, and the degree of risk is related to the WML classification.
- Parkinson disease /
- White matter lesions /
- Motor symptoms /
- Non-motor symptoms /
- Correlation

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表 1 WML组与非WML组PD患者一般资料比较

组别	例数	性别(例)		年龄(x±s，岁)	病程(x±s，年)	BMI (x±s)	基础疾病(例)
组别	例数	男性	女性	年龄(x±s，岁)	病程(x±s，年)	BMI (x±s)	高血压	糖尿病
WML组	83	46	37	62.45±7.12	5.12±1.12	25.15±4.20	31	5
非WML组	65	33	32	61.23±6.24	4.95±0.84	24.34±4.16	25	2
统计量		0.317^a		1.100^b	1.019^b	1.169^b	0.015^a	0.703^a
P值		0.573		0.277	0.309	0.244	0.890	0.476
注：^a为χ²值，^b为t值。

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表 2 2组PD患者运动障碍评分及程度比较

组别	例数	UPDRS Ⅲ评分(x±s，分)	运动障碍程度[例(%)]
组别	例数	UPDRS Ⅲ评分(x±s，分)	轻度	中度	重度
非WML组	65	18.65±4.12	42(64.62)	15(23.08)	8(12.31)
WML组	83	25.52±4.24	8(23.33)	36(40.00)	39(36.67)
统计量		9.905^a	50.776^b
P值		＜0.001	＜0.001
注：^a为t值，^b为Z值。

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表 3 自变量赋值情况

自变量	赋值方法
UPDRS Ⅲ评分	连续变量
H & Y分期重度	是=1，否=0
NMSQ评分	连续变量

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表 4 影响PD患者WML发病的多因素分析

项目	B	SE	Wald χ²	P值	OR值	95% CI
UPDRS Ⅲ评分	2.094	0.615	11.593	0.001	8.117	2.974~22.158
H & Y分期重度	1.963	0.521	14.196	0.001	7.121	2.609~19.437
NMSQ评分	2.374	0.771	9.481	0.001	10.740	3.945~29.318

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