Clinical Features Of Parkinson’s Disease Patients In Chongqing

Objective:To analyse demographic characteristics and clinical features of Parkinson’s disease (PD) patients in Chongqing. Discussing risk factors of some motor symptoms,non-motor symptoms and motor complications. So as to guide the early diagnosis of Parkinson’s disease and provide clinical basis for the establishment of long-term treatment.Methods:Retrospective review of demographic and clinical data of 177 PD patients in the outpatient department or the inpatient of our hospital. Comparing the clinical features among patients with different age at onset and different course. Analysing the correlation between H-Y stage and age, course,LEDD etc.Discussing risk factors of some motor symptoms, non-motor symptoms and motor complications.Results Mean age was 66.16±9.53 years with predominance of men (59.9%). The mean duration of disease was 5.09±4.52 years. Mean body mass index was 22.45±2.80kg/m2.Mean age at disease onset was 60.86±10.92 years. Early onset PD patients (age at onset<49 years) was recorded in 16.4% of patients. Initial symptom appeared on the right side in 57.1%. Tremor was the initial symptom in 49.2%. Mean modified H-Y stage was 2.53±1.15,and increased with increasing duration of disease and LEDD. Freezing was found in 36.2% and falls in 12.4%.And the higher H-Y stage, the higher risk for falls and freezing. Levodopa (LD) was initially introduced in 52.5% of patients, and was the first medication prescribed in 57.1% of early onset PD patients. Mean duration of LD treatment was 3.45±4.10 years. Mean LEDD was 413.36±282.76mg. MAO-B inhibitors and COMT inhibitors were rarely introduced in patients. Patients who were not treated with any medicine account for 9.6%. Comparison among groups suggested that the younger age of onset and the longer course,the higher incidence of motor fluctuations and dyskinesias. On multivariate analysis, age of onset ranging from 50 to 69 years, H-Y stage 3 to 5, combination of LD and DAs,and LEDD≥400mg were associated with fluctuations whereas age of onset≤49 years, longer course and LEDD≥400mg were identified as risk factors for dyskinesias. Neuropsychiatric symptoms developed in 85.9% and autonomic dysfunction in 81.9%, paraesthesia in 74% of PD patients. Multivariate analysis revealed the longer delay of levodopa treatment,the the higher frequency of Parkinsonism related pain.Conclusions:a) PD patients in Chongqing are suffering from heavier motor symptoms,and the incidence of non-motor symptoms is relatively hjgh. b) PD patients in Chongqing have relatively single medication, this is maybe related to the economic state of patients and the reimbursement of medical insurance.c) Not a few of early-onset PD patients chosed LD for the first medication,and a few patients were not treated with any medicine yet. Therefore, the treatment of patients with early-onset or first diagnosed remains to be further standardized. d) We should put emphasis on the outpatients who complain of weakness of unilateral limb with or without bradykinesia, these patients may gradually show the core of the PD symptoms in the follow-up visits. e) H-Y stage is positively correlated with the duration of disease and LEDD. f) Age of onset ranging from 50 to 69 years, H-Y stage 3 to 5, combination of LD and DAs, LEDD≥400mg are associated with motor fluctuations.Age of onset≤49 years, longer course and LEDD≥400mg are identified as risk factors for dyskinesias. g) When we are making decisions on the medication of PD patients, we should comprehensively consider the age of onset, motor symptoms, non-motor symptoms and motor complications etc.