帕金森病患者肺功能与运动症状相关性研究

尹慧梅; 承欧梅; 张旭; 全凤英; 周建荣

doi:10.13406/j.cnki.cyxb.003690

重庆医科大学学报 ›› 2025, Vol. 50 ›› Issue (04) : 523 -529. DOI: 10.13406/j.cnki.cyxb.003690

临床研究

帕金森病患者肺功能与运动症状相关性研究

尹慧梅 ¹ ,
承欧梅 ² ,
张旭 ¹ ,
全凤英 ¹ ,
周建荣 ³

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Association between pulmonary function and motor symptoms in patients with Parkinson’s disease

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摘要

目的旨在评估帕金森病（Parkinson’s disease，PD）患者的肺功能状况，探讨PD患者肺功能与运动症状的关系。方法纳入PD患者104例，采用便携式肺功能仪进行肺功能评估，根据肺功能结果，将患者分为伴有通气功能障碍组（37例）和不伴有通气功能障碍组（67例），比较2组的临床资料，采用单因素分析及多因素logistic回归模型探讨肺功能异常的相关因素，采用Spearman相关性分析探讨肺功能参数与运动症状的关系。结果 2 组患者的运动迟缓评分和姿势步态评分比较差异有统计学意义（P<0.05）；logistic回归分析显示，肺通气功能障碍与姿势步态评分之间呈正相关（回归系数β=0.171，95%CI=1.015~1.386，P=0.032）。不同分期PD患者的用力肺活量占预计值（forced vital capacity as percentage of predicted value，FVC%）（t=2.143，P=0.034）、第1秒用力呼气容积占预计值（forced expiratory volume in 1 second as percentage of predicted value，FEV1%）（t=2.118，P=0.037）、呼气峰值流速占预计值（peak expiratory flow as percentage of predicted value，PEF%）（t=2.002，P=0.048）、最大呼气压占预计值（maximal expiratory pressure as percentage of predicted value，MEP%）（t=2.412，P=0.018）、最大吸气压占预计值（maximal expiratory pressure as percentage of predicted value，MIP%）（t=2.119，P=0.036）差异有统计学意义。结论 PD患者的肺功能较预期值偏低，伴有肺通气功能障碍的发生率为35.58%，主要表现为限制性通气功能障碍，PD患者肺功能与运动症状存在关联。

Abstract

Objective To investigate the pulmonary function in patients with Parkinson’s disease（PD） and the association between pulmonary function and motor symptoms. Methods A total of 104 PD patients were included in the study，and a portable spirometer was used to assess pulmonary function. According to the results of pulmonary function，the patients were divided into ventilation dysfunction group with 37 patients and non-ventilation dysfunction with 67 patients，and clinical data were compared between the two groups. Univariate and multivariate logistic regression analyses were used to investigate the factors associated with abnormal pulmonary function，and a Spearman correlation analysis was used to investigate the correlation between pulmonary function parameters and motor symptoms. Results There were significant differences in the scores of bradykinesia and postural gait between the two groups（P<0.05），and the logistic regression analysis showed a positive correlation between pulmonary ventilation dysfunction and postural gait score（regression coefficient β=0.171，95%CI=1.015-1.386，P=0.032）. There were significant differences between the patients with different stages of PD in the pulmonary function parameters of the percentage of forced vital capacity in predicted value（t=2.143，P=0.034），the percentage of forced expiratory volume in 1 second（t=2.118，P=0.037），the percentage of predicted peak expiratory flow（t=2.002，P=0.048），maximum expiratory pressure as a percentage of predicted value（t=2.412，P=0.018），and maximum inspiratory pressure as a percentage of predicted value（t=2.119，P=0.036）. Conclusion The pulmonary function parameters of PD patients are lower than expected values，and the incidence rate of pulmonary ventilation dysfunction is 35.58%，with the main manifestation of restrictive ventilatory dysfunction. There is a correlation between pulmonary function and motor symptoms in PD patients.