跌倒恐惧对帕金森病患者生活质量的影响  

Impact of fear of falling on quality of life in patients with Parkinson's disease

作　　者：张扬[1] 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,南京210008

出　　处：《东南国防医药》2018年第1期6-10,共5页Military Medical Journal of Southeast China

基　　金：中央高校基本科研业务费专项基金(021414380290)

摘　　要：目的探讨跌倒恐惧对帕金森病患者生活质量的影响。方法纳入2013年6月至2015年12月期间在南京鼓楼医院就诊的帕金森病患者96例,依据活动平衡信心量表(ABC量表)将患者分为跌倒恐惧组(46例)和无跌倒恐惧组(50例)。采集入组患者的一般信息,包括性别、年龄、病程、受教育年限、药物治疗等基线情况。采用中文版帕金森病患者生活质量问卷(PDQ-39)来评估最近1个月内的生活质量状况。以Hoehn-Yahr分级、统一帕金森病评分量表的运动评分(UPDRS-Ⅲ)、跌倒史等来评估受试者运动相关的临床特征。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)来评估常见非运动症状的临床特征。结果帕金森病伴跌倒恐惧组病程明显长于无跌倒恐惧组(P<0.05)。跌倒恐惧组在UPDRS-Ⅲ、HAMA、左旋多巴等效剂量等相关因素均明显高于无跌倒恐惧组(P<0.05)。在PDQ-39量表的比较方面,跌倒恐惧组在PDQ-39总得分指数(PDQ-39 SI)、身体活动、日常生活行为、精神健康、屈辱感、认知、交流以及身体不适等方面的评分均比无跌倒恐惧组高(P<0.05)。在相关性分析方面,跌倒恐惧组ABC评分与病程、UPDRS-Ⅲ、跌倒史、HAMA等均呈显著负相关(r=-0.418、-0.541、-0.366、-0.378,P<0.05),在与PDQ-39各维度的相关性分析显示ABC评分与PDQ-39 SI、身体活动、日常生活行为、精神健康、交流、身体不适维度呈显著负相关(r=-0.713、-0.483、-0.671、-0.315、-0.349、-0.377,P<0.05)。其中,ABC评分与身体活动及日常生活行为两个维度的相关性最高(P<0.01)。结论跌倒恐惧对帕金森病患者生活质量有显著的影响,跌倒恐惧的严重程度与患者的生活质量显著相关。临床上如重视改善帕金森病患者跌倒恐惧的状况,可有效提高患者生活质量。Objective The purpose of this study is to investigate the quality of life （QoL） that affected by fear of falling （FOF） with Parkinson′s disease （PD）.Methods Ninety six PD patients were recruited between June 2013 and December 2015 from the department of Neurology, Drum tower Hospital, Medical school of Nanjing University. According to the Activities-specific Balance Confidence scale （ABC scale）, PD patients were divided into two groups： PD with FOF （n=46） and PD without FOF （n=50）. The baseline characteristics were collected, such as age, gender, duration and medical treatment, etc. The 39-item Parkinson′s Disease Questionnaire （PDQ-39） was used to evaluate the QoL of all PD patients. Hoehn-Yahr（H-Y） stage, Unified Parkinson Disease Rating Scale （UPDRS）-Ⅲ, history of falling within one year were used to evaluate movement symptoms. Mini Mental State Examination （MMSE）,Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to evaluate non-motor symptoms.Results A total of 96 PD patients participated in the research. The duration of disease of FOF group was longer than non-FOF group （P〈0.05）. PD with FOF group was more severe than non-FOF group in UPDRS-Ⅲ, HAMA, Levodopa Equivalent Dose （LED） （P〈0.05）. As to QoL, FOF group was more severe than non-FOF group in the domain of PDQ-39 scoring for single index （PDQ-39 SI）, mobility, activities of daily living, emotional well-being, stigma, cognitions, communication, bodily discomfort （P〈0.05）. In the analysis of correlation, the ABC scale score of FOF group showed significant negative correlation with duration, UPDRS- Ⅲ, falling history and HAMA （r=-0.418,-0.541,-0.366,-0.378, P〈0.05）. In the correlation analysis of PDQ-39, the ABC scale score of FOF group showed significant negative correlation with PDQ-39 SI, mobility, activities of daily living, emotional well-being, communication, bodily discomfort （r=-0.713,-0.483,-0.671,-0.315,-0.349,-0.377, P〈0.05�

关 键 词：帕金森病 跌倒恐惧 生活质量 

分 类 号：R737.9[医药卫生—肿瘤]