目的　分析 75岁以上老年人原发性帕金森病 (OEIPD)患者的临床特点和死亡原因 ,为改善OEIPD的治疗和预防提供资料。方法　对 15例OEIPD患者进行前瞻性长期临床观察 ,并结合尸检资料分析死亡原因。结果　 15例平均病程为 6 2± 3 6年 ,临床类型以少动及少动伴震颤占多数 (80 0 % )。 12例在病程后期 (发病后4 8± 3 5年 )出现呛咳 ,呛咳症状出现后平均 4个月开始鼻饲。最常见的并发症为反复呼吸道感染 ,平均 2 9±1 9次。死亡原因中支气管肺炎和感染性休克 11例 (73 3% ) ,急性心肌梗死 2例 ,心肌梗死伴心脏破裂及主动脉瘤破裂各 1例。结论　①OEIPD患者病程短 ,应及时应用复方左旋多巴治疗 ;②死亡原因多为肺炎和感染性休克 ,呛咳是肺炎主要原因之一。因此 ,出现呛咳时应尽早鼻饲 ,也应训练患者用声门上吞咽法 Objective To analyze the clinical characteristics and causes of death in patients with primary Parkinson’s disease (OEIPD) over 75 years of age and provide information for improving the treatment and prevention of OEIPD. Methods 15 cases of OEIPD patients were prospective long-term clinical observation, combined with autopsy data analysis of the cause of death. Results The average course of disease in 15 cases was 62 ± 36 years. The majority of the patients with less and less active tremor were found (80 0%). Chronic cough was found in 12 cases at the later stage of disease (48 ± 35 years after onset), and nasal feeding was started after an average of 4 months after the occurrence of cough symptoms. The most common complication was recurrent respiratory infections, with an average of 29 ± 19 visits. Eleven cases (73.3%) of bronchopneumonia and septic shock, two cases of acute myocardial infarction, one case of myocardial infarction with heart rupture and rupture of aortic aneurysm were the causes of death. Conclusion ①OEIPD patients with short course should be promptly treated with compound levodopa treatment; ② cause of death mostly pneumonia and septic shock, choking is one of the main causes of pneumonia. Therefore, cough should appear as soon as possible nasal feeding, patients should also be trained to swallow the glottis