帕金森病患者健康相关生活质量的研究  

Study of health related quality of life in patients with Parkinson＇ s disease

作　　者：刘玉梅[1] 李晶鑫[1] 房秋菊[1] 秦悦洋[2] 魏亚芬[1] 

机构地区：[1]黑龙江省医院神经内科,黑龙江哈尔滨150036 [2]黑龙江省医院物理诊断科,黑龙江哈尔滨150036

出　　处：《世界最新医学信息文摘》2013年第16期58-59,31,共3页World Latest Medicine Information Electronic Version

基　　金：黑龙江省卫生厅科研课题（课题编号：2011-656）

摘　　要：目的研究早期帕金森病（PD）患者健康相关生活质量（health．relatedqualityoflife，HR-QOL）的特点；探讨运动症状和非运动症状对早期PD患者HR-QOL的影响。方法筛选出97例早期PD患者入组。采用统一帕金森病评分表（UPDRS）和Hoehn．Yahr评价运动症状，采用流行病学研究中心编制的抑郁量表（CES-D）、匹兹堡睡眠质量指数（PSQI）、疲劳量表（FSS）分别对抑郁、睡眠障碍、疲劳等非运动症状进行评价；采用36条目简化医疗结局调查问卷（SF-36）评价HR-QOL。采用逐步多元线性回归分析深入探讨各种运动和非运动症状变量对HR．QOL的影响。结果UPDRS第3部分分值（22．7±8．9）、Hoehn-Yahr分期（2．1±0．6）和强直分值（4．3±2．7）仅能解释SF-36总分变化的19．1％（R2=O．191）。CES-D、FSS和PSQ1分值等非运动症状变量引入回归方程后，SF-36总分可被解释的部分由19．1％增加至61．9％（R2=0．619）。引入CES—D分值后，SF-36ukn总分可被解释的部分增加了43．9％（R2=0．439）。结论PD症状严重影响早期患者的HR-QOL。运动症状对HR-QOL存在影响，但影响的作用有限。抑郁、疲劳和睡眠障碍这3个非运动症状是导致早期PD患者HR-QOL恶化的主要原因。其中，抑郁症状是HR-QOL恶化强预测因素。Objective To investigate the characteristics of health related quality of life（HR-QOL） in patients with early Parkinson＇s disease（PD）, to identify the motor and non-motor factors that are associated with a poorer quality of life in patients with early PD. Methods All 97 patients with early PD were identified in a clinical-based study. Motor functions were measured by Unified Parkinson＇s Disease Rating Scale （UPDRS） and Hoehn-Yahr Scale. Non-motor variables were assessed by Center of Epidemiological Survey Depression Scale（CES-D） for depressive symptoms, Pittsburg Sleep Quality lndex（PSQI）for sleep disturbance, Fatigue Severity scale （FSS） for fatigue, HR-QOL was measured by SF-36. Multiple regression analyses Were used to determine which variable were strongly associated with lower levels of quality of life. Results The motor score of the UPDRS （22.7=e8.9）. Hoehn-Yahr stage（2.1＋0.6）, together with the rigidity score（4.3：L2.7）, only accounted for 19.1% （R2=0.191）of the variance of SF-36 total score. The variables that most strongly predicted a low total SF-36 Score were non- motor factors, particularly depressive symptoms, sleep disorders and fatigue. When the CES-D, FSS, and PSQI score were included in the model, the R2 increased from 0.191 to 0.619, indicating that 61.9 % of the variance in HR-QOL could be explained if additional CES-D,FSS and PSQI scores were known. Depressive symptoms, as measured by CES-D, had an overwhelming impact on HR-QOL. When CES-D score was included, the R2 change was 0.439. which indicated that additional 43.9 % of the variability in HR-QOL could be explained by adding depressive symptoms .Conclusions PD has a substantial impact on HR-QOL, even if in its early stage. Depressive symptoms, sleep disorders and fatigue correlated strongly with lower quality of life. Depressive symptoms appeared to be the strongest determinant of HR-QOL in early PD patients.

关 键 词：帕金森病 健康相关生活质量 抑郁 睡眠障碍 疲劳 

分 类 号：R724.5[医药卫生—儿科]