| Objective: As the well-known movement disorder, autonomic dysfunctions of parkinson’s disease involve many systems and manifest a variety of symptoms,which can influence the quality of life of PD patients,even more than motor symptoms.In this study,we investigated the autonomic function and the influenced factors of PD patients by the change of blood pressure or heart rate in sit and stand,heart rate variability,sympathetic skin response and HAMA14,HAMD24.Methods: Selecting 70 primary PD patients,50 patients in the convalescence stage of cerebral infraction,and 50 health people,treated in First Hospital of Hebei Medical from June 2013 to October 2014.General data collection:①sociodemographic information: including name,sex, age, etc; and the age of onset, progression, duration of the disease and anti-PD drugs taking,and ②clinical data: included Unified Parkinson Disease Rating Scale(UPDRS),Modified Hoehn and Yahr Staging to assessing the severity of the disease,the change of blood pressure or heart rate in sit and stand,heart rate variability(HRV),sympathetic skin response(SSR) and HAMA14,HAMD24 to evaluate the autonomic function.Results:1 PD group:70 patients,including 42 cases of men and 28 cases of women.They were 46~87 years old, average(64.89±7.58); the age of onset were 40~77 years old, average(58.95±0.94),duration 0.5~20 years,average(5.96±4.39),UPDRS score of 10~109, average(40.29±19.35); H-Y stage 1~4, average(2.18±0.7);CI group:50 patients,including 26 cases of men and 24 cases of women.They were 47~78 years old, average(66.14±8.40); Control group:50 patients,including 24 cases of men and 26 cases of women.They were 51~80 years old, average(64.48±7.12).There was no significant difference with three groups of gender or mean age.2 OH in PD group,CI group and control group were 24(34.28%)、8(16%)、4(8%),the abnormal change of heart rate in three groups were 20(28.57%)、9(18.00%)、5(10.00%).The difference of two index between three groups were statistically significant(P<0.05).Compared sex,age,durati-on,UPDRS,H-Y,SSR,HAMA14,HAMD24,the occurrence of OH was associ-ated with age(P<0.05),the abnormal change of heart rate showed no ass-ociated with those factors.3 SDNN, RMSSD, PNN50 in PD group were lower than those in CI group and the control group, the difference were statistically significant(P<0.05). There were no significant difference in LF and HF between three groups, however LF / HF was significantly different(P<0.05) in three groups.4 The abnormalities of SSR in three groups were(55.7%), 18(36.00%), 4(8%),19、7、2 in men and 20、11、1 in women.There was significantly different in SSR abnormal rate between three groups(P<0.05).The abnormalities of SSR in PD group was associated with gender,age,HAMA14, and HAMD24,other factors didn’t show significant statistically.5 Three groups existed respectively anxiety 50(71.43%), 20(40.00%), 10(20.00%) of whom were male 29,9,5 and female 21,11,5; depression was 47(67.14%), 17(34.00%), 9(18.00%) for men 28,7,6 and 19,10,3 for female; among three groups,there was statistically difference in anxiety and depres- sion(P<0.001).Conclusions:1 In PD patients,autonomic dysfunctions were more common,and the degree was more serious than CI patients and healthy people.2 Postural changes in blood pressure and heart rate,heart rate variability, sympathetic skin response were reliable indicators to reflect the autonomic function.3 anxiety and depression could affect autonomic function. |
PDF Full Text Request