目的 观察帕金森病(PD)患者的营养状态并探讨部分非运动症状对患者营养状态的影响.方法 选择自2016年5月至2017年5月徐州市中心医院神经内科收治的PD患者119例为研究对象,收集患者年龄、性别、病程、Hoehn-Yahr(H-Y)分级等基本资料,同时采用患者主观全面评价量表(PG-SGA)对患者("开期"状态下)进行评估.根据PG-SGA评估结果将患者分为:A级(营养良好状态)、B级(中度或可疑营养不良)及C级(重度营养不良).比较各级患者各类型症状出现比例并采用Logistic回归分析明确PD患者营养不良的危险因素.结果 119例患者中86例患者(72.26%)处于A级,33例(27.73%)处于B级,未见C级患者.A级与B级患者体质量、体质量指数、PG-SGA总分及H-Y分级差异有统计学意义(P<0.05).A级患者中,常见症状为口干(49例,56.98%)、便秘(43例,50.00%)和味觉异常(25例,29.07%).B级患者中,常见症状为口干(23例,69.70%),便秘(21例,63.64%)和味觉异常(18例,52.90%).其中无食欲、味觉异常或没有味道、气味难闻、早饱感、疼痛和膳食摄入量这6个项目在2组患者中的出现频率差异有统计学意义(P<0.05).无食欲(OR=10.76,95%CI:2.000~57.894,P=0.006)、早饱感(OR=4.539,95%CI:1.633~11.491,P=0.003)和疼痛(OR=4.608,95%CI:1.038~20.452,P=0.045)是PD患者营养不良状态的独立危险因素.结论 PD患者较易出现营养不良,尤其当患者出现无食欲、早饱感和疼痛症状时,应及时干预或进一步加强营养支持.
Objective To observe the nutritional status of patients with Parkinson's disease (PD) and investigate the influences of some non-motor symptoms in nutritional status. Methods One hundred and nineteen PD patients, admitted to our hospital from May 2016 to May 2017, and followed up for a long time, were chosen in our study. General clinical data, as age, gender, disease history, and Hoehn-Yahr (H-Y) grading, were collected, and the nutritional status of the patients was evaluated by subject global assessment (SGA) and patient generated subject global assessment (PG-SGA). According to the PG-SGA results, groups of grading A (well-nourished status), grading B (moderately malnourished status), and grading C (severely malnourished status) were divided. The proportion of each type of symptoms appeared in each group was compared and the risk factors of malnutrition in PD patients were determined by Logistics regression analysis. Results Among the 119 PD patients, 86 (72.26%) were classified as grading A, 33 (27.73%) as grading B, and none as grading C. There were statistically significant differences in body mass, body mass index, PG-SGA total scores and H-Y grading between patients from grading A and grading B groups (P<0.05). Among the 82 grading A patients, the common symptoms were dry mouth (n=49, 56.98%), constipation (n=43, 50.00%) and abnormal taste (n=25, 29.07%); among the 33 grading B patients, the common symptoms were dry mouth (n=23, 69.70%), constipation (n=21, 63.64%) and abnormal taste (n=18, 52.90%); there were statistically significant differences in the frequencies of anorexia, abnormal taste or no taste, bad smell, early satiety, pain and dietary intake between patients from the two groups (P<0.05). Anorexia (OR=10.76, 95%CI:2.00-57.894, P=0.006), early satiety (OR=4.539, 95%CI: 1.633-11.491, P=0.003), and pain (OR=4.608, 95%CI: 1.038-20.452, P=0.045) were independent risk factors for malnutrition in PD patients. Conclusion PD patients are prone to malnutrition; when patients have anorexia, early satiety and pain symptoms, timely intervention should be given or nutritional support should be further strengthened.