目的：分析帕金森病（ PD）合并糖尿病患者的非运动症状（ NMS）特点。方法选择2013年6月至2015年9月河北北方学院附属第一医院神经内科收治的 PD 患者114例为研究对象，其中合并糖尿病患者60例，非糖尿病患者54例，详细记录患者的临床资料，采用多种 PD评估量表，包括PD统一评定量表（UPDRS-Ⅰ）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、简易精神状态量表（MMSE）、匹茨堡睡眠质量指数量表（PSQI）、PD自主神经症状量表（SCOPA-AUT）分析其非运动症状（自主神经功能紊乱、神经精神症状、睡眠障碍和感觉症状）的临床特点及发生率。结果PD 合并糖尿病组患者的 Hoehn-Yahr 分级显著高于 PD 非糖尿病组患者[（3.06±0.92）级比（2.74±0.59）级]，差异有统计学意义（P ＝0.031）。 PD 合并糖尿病组患者的5项非运动症状量表评分包括 UPDRS-Ⅰ、HAMD、HAMA、PSQI、SCOPA-AUT，显著高于 PD 非糖尿病组患者[（5.07±2.18）分比（2.96±1.47）分，（14.65±4.88）分比（7.29±5.06）分，（16.43±6.11）分比（8.02±3.44）分，（9.07±3.37）分比（6.81±4.68）分，（39.52±8.65）分比（31.61±6.17）分]，差异有统计学意义（P＜0.01）。 PD合并糖尿病组患者的MMSE评分与PD非糖尿病组患者[（23.57±4.34）分比（21.63±6.36）分]，差异无统计学意义（P＝0.058）。 PD合并糖尿病组自主神经功能紊乱发生率显著高于PD非糖尿病组[73.33％（44／60）比55.56％（30／54）]（P＜0.05）。结论 PD患者存在不同程度的自主神经功能障碍、神经精神症状、睡眠障碍和感觉症状四种非运动症状，糖尿病病史对患者的PD严重程度、非运动症状的发生率及生活质量均有影响。%Objective To analyze the characteristic of non-motor symptoms ( NMS) of Parkinson dis-ease( PD) patients complicated with diabetes.Methods We enrolled 114 PD patients from the First Hospi-tal Affiliated to Hebei North University from Jun.2013 to Sep.2015 as the objects of our research, among which 60 patients were diagnosed with diabetes and 54 patients were nondiabetic.The clinical data of these patients was recorded in detail, and the clinical characteristics and incidence of non-motor symptoms( auto-nomic nerve dysfunction, nerve mental symptoms,sensory symptoms,sleep symptoms) were analyzed accord-ing to many kinds of PD assessment scales including unified PD rating scale(UPDRS-Ⅰ),Hamilton depres-sion scale(HAMD),hamilton anxiety scale(HAMA),mini-mental state examination(MMSE),Pittsburgh sleep quality index ( PSQI ) , and the scale for outcomes in PD for autonomic symptoms ( SCOPA-AUT ) . Results The Hoehn-Yahr grading of PD patients complicated with diabetes was significantly higher than that of PD patients without diabetes[(3.06 ±0.92) vs (2.74 ±0.59)], and the difference was statistically sig-nificant(P=0.031).For PD patients with diabetes,the five items of non-motor symptoms rating scale inclu-ding UPDRS-Ⅰ, HAMD, HAMA, MMSE, PSQI, SCOPA-AUT were significantly higher than those of PD patients without diabetes[(5.07 ±2.18) vs (2.96 ±1.47), (14.65 ±4.88) vs (7.29 ±5.06), (16.43 ± 6.11) vs 8.02 ±3.44), (9.07 ±3.37) vs (6.81 ±4.68), (39.52 ±8.65) vs (31.61 ±6.17)], and the differences were statistically significant(P<0.01).The MMSE score of PD patients with diabetes was high-er than that of PD patients without diabetes[(23.57 ±4.34) vs (21.63 ±6.36)], and the difference was not statistically significant ( P =0.058 ) .The incidence of autonomic dysfunction PD patients with diabetes was significantly higher than that in PD patients without diabetes[73.33% (44/60) vs 55.56%(30/54), P<0.05 ] .Conclusion PD patients experience different degrees of autonomic nerve dysfunction , nerve mental symptoms,sleep disorder and sensory symptoms,and history of diabetes in patients can influence the severity of PD, the incidence of the non-motor symptoms and the quality of life.
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