帕金森病患者跌倒恐惧的临床特征及危险因素分析  

Clinical features and risk factors of fear of falling in patients with Parkinson's disease

作　　者：张扬[1] 冒萧萧 管得宁[1] 徐运[1] 

机构地区：[1]南京大学医学院附属鼓楼医院神经内科,江苏南京210008 [2]南京医科大学鼓楼临床医学院神经内科,江苏南京210008

出　　处：《中国临床研究》2017年第12期1608-1611,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金(81571134)

摘　　要：目的探讨帕金森病患者跌倒恐惧的临床特征以及其危险因素。方法收集南京鼓楼医院2014年1月至2016年12月住院的帕金森病患者资料111例,根据患者活动平衡信心量表(ABC量表)评分分为跌倒恐惧组(43例,38.7%)和不伴跌倒恐惧组(68例,61.3%)。收集所有患者的性别、年龄、病程、受教育年限、药物治疗等基本情况信息。采用Hoehn-Yahr分级、统一帕金森病评分量表运动部分(UPDRS-Ⅲ)评分、冻结步态问卷(FOGQ)、Berg平衡量表(BBS)评估受试者运动症状以及运动相关的情况。应用简易精神状态量表(MMSE)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、快动眼睡眠障碍筛查问卷(RBDSQ)、埃普沃思嗜睡量表(ESS)、疲劳严重度量表(FSS)等评估受试者的非运动症状。分析帕金森病跌倒恐惧的危险因素。结果跌倒恐惧组病程明显长于非跌倒恐惧组[(5.51±2.12)年vs(3.24±1.56)年,P=0.042]。跌倒恐惧组UPDRS-Ⅲ、FOGQ评分、跌倒史例数、BBS、HAMA评分、左旋多巴等效剂量等相关因素均明显高于不伴跌倒恐惧组(P均<0.05)。Logistic多元回归结果显示,UPDRS-Ⅲ评分(B=-0.503,OR=0.529,P=0.007)、BBS分值(B=-0.005,OR=0.995,P=0.030)、FOGQ分值(B=-0.468,OR=0.627,P<0.01)均为帕金森病伴有跌倒恐惧的独立危险因素。结论跌倒恐惧是帕金森病常见的症状,其发生与症状严重程度、平衡功能及冻结步态等因素相关。Objective To investigate the clinical features and risk factors of fear of falling （FOF） in patients with Parkirlson＇s disease （PD）. Methods A total of l 11 PD patients hospitalized in Nanjing Drum Tower Hospital between January 2014 and December 2016 were recruited and were divided into PD with FOF group （FOF group, n = 43,38.7% ） and PD without FOF group （non-FOF group, n = 68,61.3% ） according to activities-specific balance confidence scale （ ABC scale）. The baseline information including gender, age, course of disease, years of education and drug treatment were collected. Hoehn-Yahr（H-Y） stage, unified Parkinson disease rating scale （UPDPtS）-l I l, freezing of gait questionnaire （ FOGQ）, Berg balance scale （BBS） were used to assess the motor symptoms and exercise-related symptoms of the objects. Mini mental state examination （ MMSE）, Hamilton depression scale （ HAMD）, Hamilton anxiety scale （ HAMA）, REM sleep behavior disorder screening questionnaire （RBDSQ）, Epworth sleepiness scale （ESS）, fatigue severity scale （FSS） were used to evaluate the non-motor symptoms of objects. The risk factors of FOF for Parkinson＇s disease were analyzed. Results The duration of disease in FOF group was statistically longer than that in non-FOF group [ （5.51 ± 2. 12）years vs （3.24 ±1.56） years, P = 0. 042 ]. The scales of UPDRS- m, FOGQ, BBS, HAMA, levodopa equivalent dose （LED） and cases of falling history in PD with FOF group were significantly higher than those in non-FOF group （all P 〈 0.05 ）. Logistic regression analysis showed that UPDRS-Ⅲ （ B = - 0. 503, OR = 0. 529, P = 0. 007 ）, BBS （ B = -0.005, OR = 0.995, P = 0.030） and FOGQ （ B = - 0. 468, OR = 0. 627, P 〈 0. 001 ） were the independent risk factors of PD with FOF.Conclusions FOF is a common symptom of Parkinson＇s disease,and its occurrence is related to the factors of symptom severity, balance function and frozen gait, etc.

关 键 词：帕金森病 跌倒恐惧 冻结步态 平衡功能 活动平衡信心量表 统一帕金森评分量表 

分 类 号：R742.5[医药卫生—神经病学与精神病学]