Clinical Study Of Visceral Autonomic Nervous Dysfunction In Patients With Parkinson’s Disease

Parkinson’s disease(PD)is a common degenerative disease of the central nervous system in the middle-aged and the elderly.The symptoms of motor delay,tremors,and rigidity are the main manifestations of Parkinson’s disease.In the past 20 years,the non-moving symptoms of PD have attracted more and more attention and research.The non-motor symptoms have a great impact on the quality of life of the patient,mainly including constipation,depression,cognitive dysfunction,olfactory disorder,and fast-moving eye-to-sleep disorder.Objective:To investigate the differences in blood pressure typing,nocturnal hypertension and heart rate variability(HRV),and anal EMG characteristics in Parkinson’s patients with different motor subtypes.Patients with Parkinson’s disease have the characteristics of visceral autonomic dysfunction mainly characterized by cardiovascular system and gastrointestinal system,and guide clinical drug intervention to improve the quality of life of patients with Parkinson’s disease.Method:Revenue from January 2017 to March 2019 in Jiangxi Provincial People’s Hospital for the clinical diagnosis of 60 patients with Parkinson’s disease as the study object,through the onset of the dominant motor symptoms and Parkinson’s disease comprehensive rating scale(UPDRS)score Sixty patients with Parkinson’s disease were divided into three subtypes of exercise(tremor subtype,dyskinesia subtype,mixed type),20 people in each group,24 h ambulatory blood pressure,dynamic electrocardiogram,anal electromyography,three groups Statistical analysis of erect hypotension,incidence of nocturnal hypertension,blood pressure typing,heart rate variability,mean time of anal EMG,mean amplitude,and percentage of multiple wave were performed to study the different subtypes of exercise.Whether there is a difference in visceral autonomic dysfunction in patients with Parkinson’s disease.Result:Among the 60 patients with Parkinson’s disease who were enrolled in the inpatient department,the tremor subtype,dyskinesia subtype and mixed type each accounted for 20,and the three groups of patients with Parkinson’s disease met the inclusion criteria.There were no significant differences in age,gender,age of onset,and duration of disease between the three groups(P>0.05).Dynamic electrocardiogram,ambulatory blood pressure monitoring and anal electromyography were performed in 60 patients.The statistical analysis showed that: First,in terms of heart rate variability,Parkinson’s disease tremor subgroup,dyskinesia group and mixed group The differences between PNN50(%),SDANN and rMSSD were not significant(P>0.05).On the observation of SDNN,the difference between dyskinesia and tremor group was significant(P<0.05),suggesting that the dyskinesia group The SDNN value was higher than that of the tremor group,which means that the heart rate variability of the dyskinesia group was more obvious than that of the tremor group within 24 hours.At the same time,the difference of SDNN between the mixed group and the tremor group was also significant(P<0.05).It is suggested that the SDNN value of the mixed group is higher than that of the tremor group,which means that the overall heart rate variability of the dyskinesia group within 24 hours is more obvious than that of the tremor group.Secondly,in terms of the dynamic blood pressure of different subtypes of Parkinson’s disease,there are significant differences in blood pressure typing among the three subtypes.There was no clear statistical support for the influence of Parkinson’s clinical subtypes on the incidence of nocturnal hypertension.Finally,a study of four observational indicators of the anal EMG found that there were no significant differences in the anal electromyography mean time,mean amplitude,and satellite potential number in the tremor group,the dyskinesia group,and the mixed group(P>0.05);in the multi-wave ratio,the mixed group was more than the dyskinesia group and the tremor group,and the difference was statistically significant(P<0.05).Conclusion:1.There was no significant difference in the incidence of nocturnal hypertension between patients with different subtypes of Parkinson’s disease;2.The overall level of heart rate variability in patients with dyskinesia subtypes and mixed Parkinson’s disease is higher than that of tremor subtypes,that is,it is more obvious in cardiovascular autonomic dysfunction;3.The ratio of multiple wave of anal electromyography in patients with mixed group Parkinson’s disease is more than that of dyskinesia subtype and tremor subtype,indicating more prominent autonomic nerve damage in digestive tract;4.In terms of blood pressure rhythm classification,the blood pressure rhythm of patients with tremor subtypes and mixed Parkinson’s disease was mainly non-sputum type;there was no significant difference between the four types of blood pressure rhythm classification in patients with dyskinesia subtypes.