目的：帕金森病（Parkinson’s disease，PD）是一种多系统受累的神经退行性疾病，既往研究表明PD患者的自主神经功能障碍可在疾病早期出现。本研究旨在探讨PD患者中自主神经功能障碍与运动症状进展的相关性。

方法：本研究共纳入738例PD患者。采用帕金森病结局量表-自主神经功能障碍评定量表（Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction，SCOPA-AUT）评估患者的自主神经功能状态，帕金森病统一评分量表修订版（Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale，MDS-UPDRS）监测患者的运动功能进展。同时使用汉密尔顿抑郁量表和汉密尔顿焦虑量表评估患者精神心理状态。所有患者随访2年，2年（±3个月）后再次评估MDS-UPDRS评分。

结果：SCOPA-AUT总评分与MDS-UPDRS总评分（P＜0.001）及第Ⅰ部分（P＝0.005）、第Ⅱ部分（P＜0.001）和第Ⅲ部分（P＜0.001）评分变化（基线与2年后随访的绝对差值）均存在显著相关性。SCOPA-AUT各亚项中消化系统、泌尿系统、心血管症状、皮肤症状及药物使用相关的自主神经功能障碍评分与MDS-UPDRS总评分及部分评分项有显著相关性，而性功能障碍与运动评分变化与MDS-UPDRS总评分及各部分评分变化均无显著相关性。

结论：自主神经功能障碍可能是PD患者运动功能进展的潜在提示指标。

Objectives： Parkinson’s disease (PD) is a neurodegenerative disorder affecting multiple systems. Previous studies have indicated that autonomic dysfunction in PD patients may manifest in the early stages of the disease. This study aims to investigate the correlation between autonomic dysfunction and the progression of motor symptoms in PD patients.

Methods： A total of 738 PD patients participated in this research. The status of autonomic dysfunction was examined by Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction (SCOPA-AUT). And the motor progression was monitored by using Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Besides, neuropsychological status was recorded using Hamilton Depression Scale and Hamilton Anxiety Scale. The participants were followed up for 2 years (±3 months) and the MDS-UPDRS was reassessed to examine the progress in motor function.

Results： The SCOPA-AUT score was significantly correlated with the total MDS-UPDRS score (P＜0.001) as well as the changes in Part Ⅰ (P＝0.005), Part Ⅱ (P＜ 0.001), and Part Ⅲ (P＜0.001) scores (absolute difference between baseline and 2-year follow-up). Among the sub-items of SCOPA-AUT, the scores for autonomic dysfunction related to digestive system, urinary system, cardiovascular symptoms, skin symptoms, and drug use showed significant correlations with the total MDS-UPDRS score and certain sub-scores. However, sexual dysfunction and changes in motor scores did not show significant correlations with the total MDS-UPDRS score or changes in any sub-scores.

Conclusions： Autonomic dysfunction could be considered as a potential predictor of motor progression in PD.