[运动和自主神经障碍对I-III H&Y期帕金森病患者疼痛综合征的影响]

Q3 Medicine
A A Pilipovich, O V Vorob'eva
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引用次数: 0

摘要

目的:探讨运动和自主神经障碍对I-III期H&Y期PD患者疼痛的影响及应用多巴胺受体激动剂(ADR)纠正疼痛的可能性。材料与方法:252例I-III期Hoehn和Yahr (H&Y) PD患者(女性128例,男性124例,42-80岁)采用以下量表进行检查:UPDRS、日常活动Sch&En、生活质量PDQ-39、MMSE、BDI、PFS-16、NMSQuest、GSRS、AUA;53例患者在6个月的时间内接受匹瑞贝地尔治疗。结果:我们的研究结果表明,疼痛综合征在PD患者中广泛流行(58.6%),从早期开始(第一阶段为50%)。最稳定的疼痛与PD分期、左旋多巴剂量、运动症状(体位障碍和运动障碍表现)和运动并发症(“非经期”和运动障碍)的严重程度以及非运动PD表现抑郁和自主神经功能障碍(便秘、吞咽障碍和尿频)有关。回归分析显示,运动并发症的严重程度和抑郁程度是疼痛发生的预测因素。I-III期PD患者在加用不良反应(匹瑞贝地尔)治疗后,疼痛综合征显著消退(分别在1.5个月和6个月后消退51%和62%);这可能是由于运动成分的改善和抑郁症的减少。结论:无论是单药治疗还是与左旋多巴制剂联合使用,匹瑞贝地尔均有助于减轻疼痛综合征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Motor and autonomic disorders influence on pain syndrome of patients with Parkinson's disease of the I-III H&Y stages].

Objective: To evaluate the influence of motor and autonomic disorders on the pain of patients with PD of the I-III H&Y stages and possibility of correcting the pain with dopamine receptor agonists (ADR).

Material and methods: 252 patients (128 women and 124 men, 42-80 years old) with PD of I-III Hoehn and Yahr stages (H&Y) were examined using the following scales: UPDRS, daily activity Sch&En, quality of life PDQ-39, MMSE, BDI, PFS-16, NMSQuest, GSRS, AUA; 53 patients were piribedil treated during 6 months.

Results: Our results indicated a wide prevalence of pain syndrome in PD patients (58.6%), starting from the early stages (50% for the Ist stage). The most stable pain associations were found with the PD stage, levodopa doses, severity of motor symptoms (postural disorders and hypokinesia manifestations) and motor complications («off-periods» and dyskinesias), as well as non-motor PD manifestations depression and autonomic dysfunctions (constipation, swallowing disorders, and frequent urination). The regression analysis showed, that the severity of motor complications and depression were the predictors of pain occurrence. The pain syndrome in patients with PD of I-III stages underwent significant regression (by 51% and 62%, after 1.5 and 6 months of therapy, respectively) after ADR (piribedil) addition to their therapy; it's probably due to improving the motor component and decreasing depressive disorders.

Conclusions: The piribedil inclusion contributes to the reduction of pain syndrome, regardless is it used in monotherapy or in conjunction with levodopa preparations.

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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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