初诊帕金森病患者的偏侧化研究
张荣桂 华 平 于翠玉 刘卫国
南京医科大学附属脑科医院，江苏 南京 210096
通信作者：刘卫国
【摘要】 目的 研究初诊未服药帕金森病患者临床偏侧化特征及相关影响因素。方法 收集2017-11—2019-09 就诊南京医科大学附属脑科医院神经内科门诊的 178 例初诊未服药帕金森病患者，采用统一帕金森病评定量表（UPDRS）、非运动症状问卷筛查表（NMS Quest）、蒙特利尔认知量表（MoCA）、简易智能状态评估量表（MMSE）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、帕金森病睡眠量表（PDSS）对受试者进行评估，根据UPDRS第三部分（UPDRS-Ⅲ）及病史分为优势侧起病组（DS-PD）及非优势侧起病组（NDS-PD），比较 2 组临床资料。结果 NDS-PD 组 UPDRS-Ⅲ评分、H-Y 分期高于 DS-PD 组，2 组比较差异均有统计学意义（P＜0.05）。多因素二元 Logistic 回归分析示，女性（OR=2.27，95% CI 1.145～4.524）及 NMS Quest 评分高（OR=1.189，95% CI 1.058～1.337）是 PD 患者非优势侧起病的危险因素。结论 性别可能是帕金森病患者偏侧起病的影响因素，非优势半球起病的 PD 患者运动及非运动症状受累更严重。在疾病早期，应更注重非优势侧起病的PD患者，并制定规范的个体化治疗方案。
【关键词】 初诊帕金森病；偏侧化；运动亚型；运动症状；非运动症状
【中图分类号】 R742.5 【文献标识码】 A 【文章编号】 1673-5110 （2022） 07-0793-05
基金项目：国家重点研发计划项目（编号：2017YFC1310300）；江苏省科技计划项目（编号：BE2019611）；江苏省自然科学基金项目（编号：BK20151077）
DOI：10.12083/SYSJ.220511
Study on lateralization of newly diagnosed patients with Parkinson’s disease
ZHANG Ronggui，HUA Ping，YU Cuiyu，LIU Weiguo
The Affiliated Brain Hospital of Nanjing Medical University，Nanjing 210096，China
Corresponding author：LIU Weiguo
【Abstract】 Objective To analyze the clinical lateralization characteristics and related influencing factors in patients with newly diagnosed Parkinson’s disease without medication. Methods A total of 178 patients with newly diagnosed Parkinson’s disease who did not take medication were enrolled in the Department of Neurology，Affiliated Brain Hospital of Nanjing Medical University from November 2017 to September 2019. The unified Parkinson’s disease rating scale（UPDRS），non-motor symptom questionnaire（NMS Quest），Montreal cognitive scale （MOCA)，Hamilton depression scale（HAMD），Hamilton anxiety scale（HAMA），Parkinson’s disease sleep scale （PDSS）was used to evaluate subjects，and they were divided into right-onset group and left-onset group according to UPDRS part III（UPDRS-Ⅲ）and medical history. Clinical data between the two groups were compared（P＜0.05）. Results The UPDRS-Ⅲ score and H-Y stage were higher in NDS-PD group than DS-PD group；Binary Logistic regression analysis showed that female（OR=2.27，95% CI 1.145-4.524）and higher NMS Quest score（OR=1.189，95% CI 1.058-1.337）were the risk factors for non-dominant side onset in patients with PD. Conclusion Gender may be an influential factor in lateral onset of PD patients. PD patients with non-dominant hemisphere onset are more seriously affected by motor and non-motor symptoms. In the early stage of the disease，more attention should be paid to PD patients with non-dominant hemisphere onset and standardized individualized treatment plans should be formulated
【Key words】 Newly diagnosed Parkinson’s disease；Lateralization；Motor subtype；Motor symptoms；Non⁃motor symptoms
