早期帕金森病患者步态特征定量分析
张 杨 蒋 森 刘 娜 钱小娟 杨新玲△
新疆医科大学第二附属医院，新疆 乌鲁木齐 830054
基金项目：国家自然科学基金（编号：81960243）；新疆维吾尔自治区科技援疆计划项目（编号：2019E0280）
作者简介：张杨，Email：457366199@qq.com
△通信作者：杨新玲，Email：457366199@qq.com
【摘要】 目的 探究早期帕金森病患者行走时的步态特征。方法 收集2020-06—2021-09 在新疆医科大学第二附属医院神经内科住院就诊的帕金森病（PD）患者 51 例（H-Y 分级≤2.5），以及同时期前来体检或来自社会的健康人群为对照组。使用GaitWatch 三维步态动作捕捉与训练系统进行步态数据的收集，对各项步态数据进行定量及相关性分析。结果 帕金森病组步态周期较对照组降低［分别为（1.41± 0.698）s、（1.43±0.586）s，P=0.004］，帕金森病组步长偏差较对照组增大［分别为（7.69±11.415）cm、（3.15±3.121）cm，P=0.007］，帕金森病组比对照组步幅降低［（62±40）cm、（88±17）cm，P＜0.001］，帕金森病组与对照组间步频、步速、支撑相、摆动相比较差异无统计学意义（P≥0.05）。帕金森病组与对照组比较，步幅与帕金森病呈正相关，步长偏差与帕金森病呈负相关。ROC 曲线分析显示，对于步长偏差，区分帕金森病组与对照组的最佳截止值为 3.5 cm（灵敏度为 0.392，特异度为 0.362，曲线下面积为 0.343）。对于步幅，区分帕金森病组与对照组的最佳截止值为 68 cm（灵敏度为 0.608，特异度为 0.936，曲线下面积为 0.815）。结论 对早期帕金森病患者量化的步态参数可以反映其步态特征，早期帕金森病患者步态周期、步幅降低，步长偏差增大。
【关键词】 帕金森病；步态特征；定量分析；步态周期；步幅；步长
ZHANG Yang, JIANG Sen, LIU Na, QIAN Xiaojuan, YANG Xinling
The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
【Abstract】 Objective To investigate the gait characteristics of patients with early Parkinson’s disease. Methods Fifty-one patients with Parkinson’s disease（PD）admitted to the Department of Neurology of the Second Affiliated Hospital of Xinjiang Medical University from June 2020 to September 2021 （H-Y rating ≤2.5）, and healthy people who came for physical examination or came from society during the same period were enrolled as the control group. GaitWatch 3d gait motion capture and training system was used to collect the gait data, and the quantitative and correlation analysis of each gait data was carried out. Results The gait cycle of PD group was lower than that of the control group（（1.41±0.698）s vs（1.43±0.586）s,P=0.004）,and the stepdeviation of PD group was higher than that of the control group （（7.69 ± 11.415） cm vs （3.15 ± 3.121） cm, P=0.007）. The step length of PD group was lower than that of the control group（（62±40）cm vs（88±17）cm,P<0.001）.There were no significant differences in step frequency, step speed, strut phase and swing phase between the PD group and control group（P≥0.05）. Compared with the control group, stride length was positively correlated with Parkinson’s disease, and step deviation was negatively correlated with Parkinson’s disease. ROC curve analysis showed that the optimal cut-off value for step size deviation, the best cutoff value to distinguish PD group from control group was 3.5 cm（sensitivity was 0.392,specificity was 0.362,area under curve was 0.343）.For stride length,the best cutoff value to distinguish PD group from control group was 68 cm（sensitivity was 0.936, specificity was 0.608, area under curve was 0.815）.Conclusion Quantified gait parameters can reflect the gait characteristics of early PD patients, gait cycle and stride length decrease, and step deviation increases.
【Key words 】 Parkinson’s disease；Gait feature；Quantitative analysis；Gait cycle；Stride length；Stepdeviation