The Clinical Studies Of Autonomic Dysfunctions In Parkinson's Patients

Objective:The purposes of the study were:1.to assess the clinical features and influence factors of autonomic symptoms;2.to correlate the autonomic dysfunction with motor symptoms and other non-motor symptoms in PD;3.to explore the diagnostic value of sympathetic skin response in PD with autonomic dysfunctions.Methods:Selecting 98 primary PD patients and 30 health people treated in the First Hospital of Jilin University from October 2014 to October 2016,record the basic information of all the people(including name,sex,age,degree of education,etc)and the duration of the disease,starting symptoms,starting symptoms,Hoehn and Yahr Staging and medications of PD patients.By using the SCOPA-AUT to assess autonomic dysfunction,using the UPDRS??HAMA14?HAMD24?PDSS?ESS?Mo CA ? MMSE to evaluate motor symptoms and other non-motor symptoms.SSR were performed in 36 PD patients and 16 health people.Results:1.Excluding 8 cases invalid questionnaires,remained 120 cases,including 90 cases of PD patients and 30 cases of health people.There were no difference in sex,age,degree of education between the PD group and the healthy control group.In the score of motor symptoms and other non-motor symptoms,the PD group was significantly higher than the healthy control group,it shows that PD not only has the typical motor symptoms,but also has non motor symptoms.2.By SCOPA-AUT assessment,76 PD patients(84.4%)complained of autonomic symptoms,SCOPA-AUT score of 0-49,average(15.72±12.68).Gastrointestinal symptoms(81.1%)and urinary system(76.7%)are the most common symptoms,followed by cardiovascular system(46.7%),thermoregulation(41.1%),sexual dysfunction(35.6%)and the pupil to adjust(13.3%).Among these autonomic dysfunction,constipation was ranked the highest,followed by enuresis noctuma,dysphagi,salivate.7 health people complained of autonomic symptoms,SCOPA-AUT score of 0-7,average(1.33 ± 2.01).In PD patients,the incidence and severit of autonomic dysfunction was higher than those of healthy people.3.By SCOPA-AUT assessment,those with higher SCOPA-AUT scale score were significantly older,had longer disease duration,more severely affected,more dose of madopar and were also had more serious in anxiety,depression,cognitive,sleep at night.There was no difference in gender,the starting site,the starting symptoms,degree of cultural,dytime sleepiness.It is affected by duration,severity of the disease,motor symptoms and sleep disorder at night.4.The abnormal rates of SSR in three groups were 62.5%(15/24),33.3%(4/12),12.5%(2/16).It was significantly different to compare the SSR latency and amplitude of three groups.Conclusion:1.Autonomic dysfunctions are common in PD patients,gastrointestinal system and urinary system are involved in the most common,the most common symptoms are constipation and enuresis noctuma.2.Autonomic dysfunction is closely correlated with motor and other non-motor symptoms.It is affected by duration,severity of the disease,motor symptoms and sleep disorder at night.3.SSR was useful for evaluating the autonomic nerve lesions in PD patients,it could also find the subclinical lesions.