摘要
目的基于免疫炎症指标综合分析帕金森病(Parkinson's disease,PD)患者共病及联合用药的特点,为进一步指导和优化PD患者治疗方案提供临床依据。方法以新疆神经系统疾病临床研究中心2020年10月-2023年3月收治的527例PD患者为研究组,随机抽取同期526例体检健康人群为对照组,对比分析PD患者年龄、性别、血小板(PLT)、中性粒细胞(N)、淋巴细胞(LYM)计数,及PD患者共病及联合用药分布特点。进一步对系统性免疫炎症指数(SII)、中性粒细胞/淋巴细胞计数比值(NLR)进行亚组分析。结果与对照组比较,研究组N水平、SII、NLR升高,PLT、LYM降低,差异均有统计学意义(P<0.05)。PD患者共病数量最多达8种,联合用药品种最多达23种。随着患者年龄的增高,共病数量及用药品种数均增加(P=0.000)。PD患者共病数量和用药品种数间存在弱强度相关性(Cramer's V=0.296,P<0.001)。亚组分析显示,长期使用神经营养药、缓泻药及第二类精神药的PD患者共病数量、用药品种数增多,差异有统计学意义(P<0.05)。与不需长期服用营养神经药的PD患者比较,需长期服用营养神经药的PD患者占患者总数的53.42%,SII、NLR及N升高,LYM及PLT降低,差异无统计学意义(P>0.05)。与不需长期服用第二类精神药的PD患者比较,需长期服用第二类精神药的PD患者占患者总数的30.61%,N降低,PLT升高,差异均有统计学意义(P<0.05)。与不需长期服用缓泻药的PD患者比较,需长期服用缓泻药的PD患者占总患者人数的30.61%,LYM及PLT降低,差异均有统计学意义(P<0.05)。结论在PD诊治过程中应关注患者年龄、血细胞炎症因子计数及免疫炎症指数,对及早优化PD患者外周神经营养、调节便秘及睡眠等共病及联合用药具有临床价值。
Objective Based on the comprehensive analysis of immune inflammation indicators,the characteristics of comorbidities and combination therapy in Parkinson's disease(PD)patients are analyzed,providing clinical basis for further guidance and optimization of treatment plans for PD patients.Methods A total of 527 PD patients admitted to the Xinjiang Clinical Research Center for Neurological Diseases from October 2020 to March 2023 were selected as the study group.A total of 526 healthy individuals who underwent physical examinations during the same period were randomly selected as the control group.The age,gender,platelet(PLT),neutrophil(N),lymphoid cell(LYM)counts,as well as the distribution characteristics of comorbidities and combination therapy in PD patients were compared and analyzed.Further subgroup analysis was conducted on the Systemic Immune Inflammation Index(SII)and Neutrophil/Lymphocyte Count Ratio(NLR).Results Compared with the control group,the N level,SII,and NLR in the study group was increased,while PLT and LYM was decreased,and the differences were statistically significant(P<0.05).The maximum number of comorbidities among PD patients was 8,and the maximum number of combined medication varieties was 23.As the patient ages,both the number of comorbidities and the variety of medications wereincreased(P=0.000).There was a weak correlation between the number of comorbidities and the number of medication types in PD patients(Cramer's V=0.296,P<0.001).Subgroup analysis showed that the number of comorbidities and types of medication in PD patients who used neurotrophic drugs,laxatives and second-class psychotropic drugs for a long time were increased,and the difference was statistically significant(P<0.05).Compared with PD patients who do not require long-term use of nutritional nerve drugs,PD patients who require long-term use of nutritional nerve drugs account for 53.42%of the total number of patients.SII,NLR and N wasincreased,while LYM and PLT wasdecreased,and the difference was not statistically significant(P>0.05).Compared with PD patients who do not require long-term use of second-class psychotropic drugs,PD patients who required long-term use of second-class psychotropic drugs account for 30.61%of the total number of thepatients,with a decrease in N and an increase in PLT,and the differences were statistically significant(P<0.05).Compared with PD patients who did not require long-term use of laxatives,PD patients who required long-term use of laxatives account for 30.61%of the total number of the patients,with a decrease in LYM and PLT,and the difference was statistically significant(P<0.05).Conclusion In the diagnosis and treatment of PD,attention should be paid to the patient's age,blood cell inflammatory factor count and immune inflammatory index,which has clinical value for early optimization of peripheral nerve nutrition,regulation of comorbidities such as constipation and sleep,and combination therapy in PD patients.
作者
李亚昙
古丽米拉·阿不都卡哈
刘丹
杨新玲
LI Yatan;Gulimila Abudukaha;LIU Dan;YANG Xinling(Department of Pharmacy,the Second AffiliatedHospital,Xinjiang Medical University,Urumqi 830011,China;Xinjiang Key Laboratory of Neurological Disorder Research,Urumqi 830000,China;Xinjiang Clinical Research Center of Neurological Diseases,Urumqi 830011,China;Xinjiang Medical University,Urumqi 830017,China)
出处
《新疆医科大学学报》
CAS
2024年第1期109-112,120,共5页
Journal of Xinjiang Medical University
基金
国家自然科学基金项目(82160232)
乌鲁木齐市水磨沟区科学技术计划项目。
关键词
帕金森
免疫炎症
合并症
用药特点
Parkinson
immunoinflammatory
comorbidity
pharmacy characteristic
