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目的:评价帕金森病（PD）运动并发症风险分层治疗方案在改善患者生活质量和运动症状、延缓运动并发症等方面的临床疗效。方法:研究对象来自2019年11月到2020年6月期间于上海交通大学医学院附属新华医院专病门诊或住院的PD患者，已接受药物治疗但未发生运动并发症，帕金森病生活质量问卷-8指数（PDQ-8 SI）>18.59。基线时，采集人口学特征、PD病史，左旋多巴用量（LD）、左旋多巴等效剂量（LED），完成PDQ-8、统一帕金森病评定量表（UPDRS）-Ⅱ和Ⅲ、汉密尔顿焦虑量表-14（HAMA-14）、汉密尔顿抑郁量表-24（HAMD-24）、简易智能状态测验（MMSE）、匹茨堡睡眠指数（PSQI）和爱泼沃斯嗜睡量表（ESS）的评估，评价PD患者运动并发症发生风险，依次分为症状波动和异动症高、中、低危组，分层制定用药方案。在随访6、12个月时复测上述指标；在随访3、9个月时记录用药信息、运动并发症（症状波动和异动症）和药物不良反应，完成PDQ-8评估。结果:251例PD患者完成1年随访，男135例，女116例。基线时，年龄［n M（n Q1，n Q3）］为66（60，71）岁，PDQ-8 SI［n M（n Q1，n Q3）］为31.2（21.9，40.6）分。15.9%（40/251）患者处于症状波动高危，7.2%（18/251）处于异动症高危；不同风险组的发病年龄、病程、治疗时程、UPDRS-Ⅱ和Ⅲ评分、H&Y分级、PDQ-8 SI评分差异有统计学意义（均n P<0.05）。随访12个月时，总人群PDQ-8 SI为12.5（9.4，18.8）分，ΔPDQ-8 SI为-15.6（-21.9，-9.4）分，ΔUPDRS-Ⅲ为-9（-16，-4）分，较基线差异有统计学意义（均n P<0.05）。症状波动高危组ΔUPDRS-Ⅱ与症状波动低、中危组差异有统计学意义（n P<0.05）；异动症高危组ΔPSQⅠ、ΔLD和ΔLED与异动低、中危组差异有统计学意义（均n P18.59. At baseline, the demographic characteristics, PD medical history, levodopa dosage (LD) and levodopa equivalent dosage (LED) were collected, and the evaluation of PDQ-8, Unified Parkinson′s disease rating scale (UPDRS)-Ⅱ and Ⅲ, Hoehn and Yahr (H&Y) grade, Hamilton anxiety scale-14 (HAMA-14), Hamilton depression scale-24 (HAMD-24), mini-mental state examination (MMSE), Pittsburgh sleep quality index (PSQI), and Epworth sleepiness scale (ESS) tools was accomplished in all participants. Meanwhile, a Parkinson′s disease risk estimation scale for motor complications was used to assess patients′ risk of motor complications, and thus the medication was stratified in PD patients accordingly. During the 6-month and 12-month follow-ups, the evaluation of the above-mentioned parameters was repeated in all participants. At the 3-month and 9-month follow-ups, the information of anti-PD medications, the occurrence of motor complications (motor fluctuations and dyskinesia) and adverse drug reactions were recorded, and PDQ-8 was also evaluated.Results:Two hundred and fifty-one patients completed the 1-year follow-up, with 135 males and 116 females. At baseline, the median age of the patients was 66 (60, 71) years and the median PDQ-8 SI was 31.2 (21.9, 40.6). Additionally, 15.9% (40/251) of the patients were at high risk of motor fluctuation, and 7.2% (18/251) were at high risk of dyskinesia. There were significant differences in the age of onset, disease duration, PD treatment duration, the scores of UPDRS-Ⅱ and Ⅲ, H&Y Grade, and PDQ-8 SI among PD patients of different risk groups (alln P<0.05). In the 12th month, the median of PDQ-8 SI, Δ PDQ-8 SI and Δ UPDRS-Ⅲ was 12.5 (9.4, 18.8), -15.6 (-21.9, -9.4) and -9(-16, -4), respectively, which was statistically different from that of baseline (all n P<0.05). The change of UPDRS-Ⅱ scores in the group with high risk of motor fluctuation was statistically different from that in the groups with low and moderate risk (n P<0.05). The changes of PSQI score, LD and LED in the group with high risk of dyskinesia was statistically different from those in the groups with low and moderate risk (alln P<0.05). During the follow-up, the incidence of motor fluctuation and dyskinesia was 9.56% (24/251) and 5.97% (15/251), respectively.n Conclusion:The stratification medical treatment might have a positive intervention effect on promoting a better quality of life, improving motor symptoms and delaying motor complications in PD patients.