Study On The Effect Of Helicobacter Pylori Infection On Parkinson's Disease In Qinghai

Objective: To explore the influencing factors of Helicobacter pylori(Hp)infection in patients with Parkinson's disease(PD)in Qinghai,we observed the effect of Hp eradication treatment on motor and non-motor symptoms of PD patients.Methods: We collected 158 patients with primary PD from the Parkinson's disease clinic of Qinghai Provincial people's Hospital(average altitude 2260 meters)from September 2017 to December 2019.The clinical data were collected by general situation questionnaire,and the information of sex,age,nationality and course of disease were recorded in detail.According to the results of 13 C breath test,they were divided into Hp infection group and Hp non-infection group.The motor symptoms and complications of patients with PD were evaluated by Parkinson's disease rating scale(MDS-UDPRS),modified Hoehn-Yahr stage and WOQ-9 scale.The non-motor symptoms of PD patients were evaluated by Hamilton Depression scale(HAMD),Hamilton anxiety scale(HAMA),Mini Mental State examination scale(MMSE),Pittsburgh Sleep quality Index(PSQI),activity of Daily living scale(ADL),constipation scoring system(CSS),Leeds dyspepsia questionnaire(LDQ)and so on.The influencing factors of PD complicated with Hp infection were analyzed.Furthermore,62 Hp-infected PD patients were selected as treatment group A(eradication of Hp plus anti-PD therapy)and Hp non-infected PD patients as treatment group B(anti-PD treatment).The changes of motor and non-motor symptoms of PD patients were observed before and 8 weeks after treatment.Results: 1.The Hp infection rate of PD patients in Qinghai was 60.1%.2.In terms of non-motor symptoms: the incidence of dyspepsia,constipation,anxiety and depression in the Hp infection group was higher than that in the non-Hp infection group,and the difference between the two groups was statistically significant(P <0.05).The CSS,HAMA,HAMD and LDQ scores of patients in Hp infection group were higher than those in Hp non-infection group,the difference was statistically significant(P <0.05).In terms of motor symptoms: the rate of end-drug occurrence in the Hp infection group was higher than that in the Hp non-infection group,and the difference was statistically significant(P <0.05).The total scores of UPDRS-?,UPDRS-?,UPDRS and H-Y of patients in Hp infection group were higher than those in Hp non-infection group,the difference was statistically significant(P <0.05).The patients with advanced disease in the Hp infection group(70.4%)were higher than those in the Hp non-infection group(29.6%).Logistic regression analysis found that constipation,dyspepsia,and advanced disease were independent risk factors for PD with Hp infection 3.Comparison between treatment group A(eradication of Hp plus anti-PD therapy)and treatment group B(anti-PD treatment): Before treatment,the UPDRS?,UPDRS?,LDQ and CSS scores of group A were higher than group B,the difference was statistically significant(P <0.05).After 8 weeks of treatment,the UPDRS ? score,UPDRS ? score and off-period time of group A were lower than group B,the difference was statistically significant(P <0.05).Comparison within the group: HY classification,off-period time,HAMA,HAMD,LDQ and CSS scores of group A were significantly lower than before treatment,and the on-period time was higher than before treatment.The UPDRS ? score and UPDRS ? score of group A and group B after treatment for 8 weeks were lower than those of group A and group B before treatment.The total effective rate of treatment in group A(87.1%)was significantly higher than that in group B(67.7%),the difference was statistically significant(P <0.05).During the course of treatment,there was no significant difference in adverse events between the two groups(P> 0.05).Conclusions: 1.This study found that the Hp infection rate of PD patients in Qinghai was 60.1%,which was higher than that of related studies at home and abroad.2.The non-motor and motor symptoms of PD patients with Hp infection such as dyspepsia,constipation,anxiety,depression,motor function,motor complications and the degree of middle and late stage of PD infection in Qinghai were more serious than those of Hp non-infected patients.After correcting the confounding factors,it was found that constipation,dyspepsia and the degree of middle and late stage were the independent risk factors of PD complicated with Hp infection.3.Hp eradication therapy can not only improve the curative effect of PD patients in Qinghai,reduce the occurrence of motor complications,but also improve dyspepsia and constipation,anxiety and depression.