Abstract: Background　Parkinson's disease （PD） is a progressive neurodegenerative disease，which is the third leading cause of death in the elderly.In recent years，an increasing number of studies have found that non-motor symptoms in PD especially pain seriously affect the quality of life，to which clinicians should pay more attention and then give reasonable treatment to relieve the psychological pressure of these patients and their families.Objective　To perform a comparative analysis of the relationships of pain with dyskinesia and quality of life in PD and vascular parkinsonism （VaP） patients.Methods　Participants receiving outpatient or inpatient treatment were recruited from Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled from January 2017 to January 2019，including 65 with PD and 65 with VaP.General data were collected.The King's Parkinson's Disease Pain Scale （KPPS），UPDRS-Ⅲ 〔Motor Examination，part 3 of the Unified Parkinson's Disease Rating Scale （UPDRS-Ⅲ）〕，Hospital Anxiety and Depression Scale （HADS），and 39-item Parkinson's Disease Questionnaire （PDQ-39） were used to measure the item of pain，level of dyskinesia，prevalence of anxiety and depression，and quality of life，respectively，in all patients.Hoehn and Yahr （HY） Scale was used to assess the stage of PD.Results　Compared with PD patients，VaP patients had greater mean age and BMI，higher prevalence of hypertension and diabetes，higher mean UPDRS-Ⅲ score，but shorter mean duration of disease，lower mean KPPS score and lower incidence of pain（P<0.05）.Compared with PD patients with pain，VaP patients with pain had greater mean age，lower mean duration of disease，and lower prevalence of pain occurring in the shoulder，back and neck （P<0.05），pain occured more freguently in shoulder back and lumbar in PD while lower limds and lumbar in VaP（P<0.05）.The motor symptoms were relieved by dopaminergic drugs （mainly levodopa） in all PD patients with pain，but only in 72.4% （n=21） of VaP patients with pain.Compared with PD patients without pain，PD patients with pain had higher mean disease severity level，UPDRS-Ⅲ score，anxiety score，depression score，and PDQ-39 score （P< 0.05）.VP patients with pain had lower mean BMI and higher mean PDQ-39 score than those without （P<0.05）.Conclusion　Patients with PD and VaP both are prone to pain.The more severe the motor symptoms and emotional disorders are，the more likely they will suffer from pain and the worse quality of life they will have.Clinicians should strengthen their understanding of pain in these diseases and standardize the pain management to improve patients' quality of life.

Key words: Parkinson disease, Vascular parkinsonism, Pain, Movement disorders, Anxiety, Depression, Quality of life, Degenerative diseases

摘要： 背景　帕金森病（PD）是一种终身进展的神经系统退行性疾病，是导致中老年人群死亡的第三大因素。近年来，越来越多的研究发现在PD中非运动症状严重影响着患者的生活质量，其中疼痛是困扰最严重的非运动症状，需要临床医生重点关注并给予合理的治疗以此减轻患者及家属的精神负担。目的　收集统计并比较PD和血管性帕金森综合征（VaP）患者疼痛发生情况，分析疼痛与运动障碍及生活质量的关系。方法　选取2017年1月—2019年1月安徽医科大学附属省立医院住院及门诊诊治的PD及VaP患者各65例，收集患者的一般资料，使用基于评分的King's帕金森疼痛量表（KPPS）收集患者的疼痛信息，分为伴有和不伴疼痛患者。依据HY分级评估PD患者疾病严重程度，使用统一帕金森评定量表运动症状部分（UPDRS-Ⅲ）评估患者运动障碍程度，医院焦虑抑郁自评量表（HADS）评估患者抑郁和焦虑，帕金森患者生活质量问卷（PDQ-39）评估患者的生活质量。结果　VaP患者年龄大于PD患者，病程短于PD患者，合并高血压、糖尿病比例高于PD患者，体质指数高于PD患者，KPPS评分低于PD患者，UPDRS-Ⅲ评分高于PD患者，疼痛发生率低于PD患者（P<0.05）。VaP疼痛患者年龄大于PD疼痛患者，病程短于PD疼痛患者，疼痛部位位于肩背及颈椎所占比例低于PD疼痛患者（P<0.05）。PD患者疼痛部位多见于肩背、腰椎、下肢等，VaP患者疼痛部位多见于下肢及腰椎。所有伴有疼痛的PD患者接受了多巴胺能药物（左旋多巴为主）缓解其运动症状，伴有疼痛的VaP患者中21例（72.4%）接受多巴胺能药物（左旋多巴为主）缓解其运动症状。伴有疼痛的PD患者疾病严重程度、UPDRS-Ⅲ评分、焦虑评分、抑郁评分、PDQ-39评分高于不伴疼痛者（P<0.05）。伴有疼痛的VaP患者体质指数小于不伴疼痛者，PDQ-39评分高于不伴疼痛者（P<0.05）。结论　PD及VaP患者均易出现疼痛，运动症状、情绪障碍越严重，患者疼痛发生率越高，生活质量越差。临床医生应加强对该类疾病疼痛的认识，并对其规范化治疗，以提高患者生活质量。

关键词: 帕金森病, 血管性帕金森综合征, 疼痛, 运动障碍, 焦虑, 抑郁, 生活质量, 退行性疾病