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学科主题: 神经病学
题名:
航天中心医院周边社区帕金森病患病率及高危人群现况性调查研究
作者: 商梦晴
答辩日期: 2016-05-30
导师: 杜继臣
专业: 神经病学
授予单位: 北京大学
授予地点: 北京大学航天临床医学院
学位: 硕士
关键词: 帕金森病 ; 患病率 ; 高危人群 ; 运动症状 ; 非运动症状 ; 灵敏度 ; 特异度 ; 保护因素 ; 危险因素
其他题名: Study on the prevalence of Parkinson's disease and the status of high-risk population in the communities of Aerospace Central Hospital
分类号: R742.5
摘要:

目的:了解航天中心医院周边≥40岁人群帕金森病(Parkinson’s disease,PD)的患病率及相关影响因素,分析国际通用的帕金森病调查问卷在帕金森高危人群筛查中的灵敏度及特异度。

方法:连续随机选取自2015年8月至2016年1月航天中心医院周边(主要为永定路社区、田村社区)≥40岁人群。方法一:采用国际通用的9个问题PD调查问卷筛查出高危人群,同时收集一般人口学资料;方法二:在9个问题的基础上,结合PD主要的4个非运动症状(non-motor symptom, NMS)及相关既往病史筛查。所有的调查对象均通过运动障碍病专家以面对面方式进行临床诊断。采用SPSS 20.0统计学软件进行数据分析。

结果:共收集2326名被调查者的完整资料。最终临床诊断PD44人,年龄40~86岁,平均患病年龄72.00±10.12岁,患病率为1.89%;40~59岁、60~79岁和≥80岁三个年龄段人群的患病率分别为0.46%、2.67%和3.10%,组间差异有统计学意义(P<0.001)。方法一、二分别筛查出高危人群374人(16.08%)和188人(8.08%),临床诊断的患者中39人属于方法一筛查出的高危人群,42人属于方法二筛查出的高危人群。方法一的灵敏度为88.64%,特异度85.32%,约登指数0.74;方法二的灵敏度为95.45%,特异度93.60%,约登指数0.89。单因素分析与多因素Logistic回归分析结果显示:年龄、家族史、毒物接触史及重金属接触史可能增加PD的患病风险,是PD的危险因素;饮茶史可能降低PD的患病风险,是PD的保护因素。

结论:

1.航天中心医院周边≥40岁人群PD患病率为1.89%,与以往研究结果相似。

2.年龄、家族史、毒物接触史及重金属接触史可能是PD的危险因素,饮茶可能是PD的保护因素。

3.国际通用的PD调查问卷灵敏度较高,但特异度、约登指数相对不高,可结合非运动症状及既往病史,提高筛查效率。

英文摘要:

Objective: To investigate the prevalence and related factors of Parkinson's disease (PD) in people at age of ≥40 years living in the communities of Aerospace Central Hospital and to analyse the sensitivity and specificity of international PD questionnaire in screening of high-risk population of PD.

Methods: People at age of ≥40 years living in the communities (mainly Yongding and Tiancun) of Aerospace Central Hospital were recruited during the period from August 2015 through January 2016. Firstly the high-risk population were screened using PD questionnaire (9 questions) and general demographic data were collected. Second screening was made combining 9 questions with four major non-motor symptom (NMS) of PD and previous history. All of the subjects were clinically diagnosed by specialists face-to-face. All statistical analyses were performed using the statistical software SPSS version 20.0.

Results: Two thousand and three hundred and twenty six complete datas were collected. In all the respondents, 44 cases were with clinical diagnoses of PD, age 40~86 years old, average age 72.00 ± 10.12 years old, the prevalence of PD was 1.89%. The prevalence of PD was 0.46%, 2.67% and 3.10% in the subjects aged 40~59 years, 60~79 years and ≥80 years, respectively, and the chi-square test showed significant difference in the PD prevalence (P<0.001). Three hundred and seventy-four (16.08%) and one hundred and eighty-eight (8.08%) subjects were screened out through the first and second screening, 39 and 42 cases (clinical diagnoses of PD) were from each high-risk population result, respectively. The sensitivity, specificity and Youden index were 88.64%, 85.32% and 0.74 of the International PD questionnaire, The sensitivity, specificity and Youden index were were 95.45%, 93.60% and 0.89 when combing questionnaire with NMS and previous history. The result of single factors analysis and multivariate logistic regression analysis showed that age, family history, history of toxic exposure and exposure to heavy metals were the risk factors which increased the risk of PD while tea drinking was the protective factor which reduced the risk of PD.

Conclusion:

1. The prevalence of PD in people at age of ≥40 years living in the communities of Aerospace Central Hospital is 1.89%. The results are similar to those of previous studies.

2. Age, family history, history of toxic exposure and exposure to heavy metals are the risk factors, tea drinking is the protective factor.

3. International PD questionnaire is highly sensitive, but the specificity and Youden index were relatively low, screening shall be improved combining with NMS and previous history.

 

语种: 中文
相关网址: 查看原文
内容类型: 学位论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/125284
Appears in Collections:北京大学航天临床医学院_学位论文

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作者单位: 北京大学航天临床医学院

Recommended Citation:
商梦晴. 航天中心医院周边社区帕金森病患病率及高危人群现况性调查研究[D]. 北京大学航天临床医学院. 北京大学. 2016.
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