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本研究の目的は,パーキンソン病(Parkinson's disease:PD)患者の最大舌圧を測定し,嚥下動態および嚥下障害の臨床的評価,運動症状との関連について検討することである.対象はPD患者21名(平均年齢71.0歳)とし,最大舌圧はJMS舌圧測定器を用いて測定した.最大舌圧と嚥下障害重症度,スクリーニングテスト,嚥下造影所見との関連について検討を行った.さらに,Hoehn-Yahr(HY)の重症度,罹病期間,4大症状についても同様に調査した.全対象者の最大舌圧は26.1±9.5kPaであり,同年代の健常高齢者に比べ低値であった.嚥下造影検査で誤嚥および多量の咽頭残留を認めたPD患者群では,最大舌圧が有意に低下していた(p<0.05).最大舌圧はHY重症度(r=−0.49,p<0.05),改訂水飲みテスト(r=0.57,p<0.05)とそれぞれ有意な相関を認めた.本研究の結果から,PD患者において,最大舌圧の低下は誤嚥や咽頭残留など主に咽頭期に生じる嚥下障害も反映する可能性がある.
The objective of this study was to investigate the relationship between maximum tongue pressure, dysphagia, and motor symptoms in Parkinson's disease (PD) patients. The subjects were 21 PD patients with a mean age of 71.0 years. Maximum tongue pressure was measured using a tongue pressure measuring instrument made by JMS Co. Ltd., Japan. Patients were evaluated according to their Hoehn and Yahr (HY) scale rating, disease duration, clinical symptoms of PD, dysphagia severity scale rating, dysphagia screening test results, and videofluoroscopic examination results. The maximum tongue pressure among these PD patients was 26.1±9.5 kPa, which is lower than normal for this age group. The maximum tongue pressure was significantly less in the aspiration group and pharyngeal residue group. It correlated significantly with the scores on the HY scale (r=−0.49) and modified water swallowing test (r=0.57). This study suggests that maximum tongue pressure reflects the functional status of pharyngeal phase of swallowing, and that measuring tongue pressure is useful in evaluating swallowing of PD patients.
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