帕金森病患者疲劳症状的临床特点及相关因素分析  

Clinical characteristics of fatigue and its related factors in patients with Parkinson's disease

作　　者：许友清[1] 任粹萍 李娟[1] 陈先文[1] Xu Youqing;Ren Cuiping;Li Juan(Dept of Neurology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《安徽医科大学学报》2018年第10期1589-1593,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金(编号:1608085MH170)

摘　　要：目的探讨帕金森病(PD)患者疲劳症状的临床特点及相关因素。方法连续收集91例PD患者的人口学资料和临床资料;采用疲劳严重度量表(FSS)和多维度疲劳量表(MFI-20)评估PD患者疲劳症状,并对所有患者进行统一PD评分量表(UPDRS)、Hoehn-Yahr(H-Y)分级、简易精神状态检查量表(MMSE)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量量表(PSQI)和爱泼沃斯思睡量表(ESS)评定。结果根据FSS的评估结果,91例PD患者中,有47例患者存在疲劳症状(FSS分值>4分),疲劳发生率为51.65%;疲劳组(FSS分值>4分)与非疲劳组(FSS分值≤4分)在性别、年龄、受教育程度等方面差异无统计学意义;疲劳组的病程、H-Y分级、左旋多巴等效剂量(LED)、UPDRSI-IV评分、HAMA、HAMD、PSQI及ESS评分均高于非疲劳组。Logistic回归分析显示,日间思睡程度(ESS)及运动症状评分(UPDRSⅢ)是FSS评分的独立危险因素。相关性分析表明MFI-20的躯体疲劳评分与精神疲劳评分无相关性。多重线性回归分析显示躯体疲评分与H-Y分期显著相关,而精神疲劳评分与HAMA、HAMD评分呈显著相关性。结论帕金森病患者中疲劳的发生率较高,与多个运动和非运动症状有关。帕金森病患者躯体疲劳与精神疲劳两者的相关因素不同,躯体疲劳主要与运动症状及疾病的严重程度有关,而精神疲劳更多受到情绪因素的影响。Objective To investigate the characteristics and the related factors of fatigue in Parkinson’s disease(PD)patients.Methods The demographic and clinical information of 91 patients with idiopathic PD were collected.The fatigue severity scale(FSS)and multidimensional fatigue scale(MFI-20)were used to evaluate the fatigue symptoms of PD patients.All patients were assessed with Unified Parkinson’s Disease Rating Scale(UPDRS),Hoehn-Yahr(HY)stage,Mini-mental State Examination(MMSE),Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD),Pittsburgh Sleeping Quality Index(PSQI),and Epworth Sleepiness Scale(ESS).Results According to the results of FSS,47 of 91 PD patients suffered from fatigue(FSS score>4),the incidence of fatigue was 56.4%.There were no significant differences between fatigue group(FSS>4)and non-fatigue group(FSS≤4)in gender,age and educational level.The disease duration,scores of H-Y,Levodopa equivalent dose(LED),UPDRSI-IV,HAMA,PSQI and ESS in fatigue group were higher than those in non-fatigue group.Logistic regression analysis showed that the scores of ESS and UPDRSⅢwere independent risk factors for the scores of FSS.Correlation analysis showed that there was no correlation between physical fatigue score and mental fatigue score.Multiple linear regression analysis showed that physical fatigue score was related with H-Y stage,mental fatigue score was significantly associated with HAMA and HAMD.Conclusion PD patients have high incidence of fatigue which is associated with a variety of motor and non-motor symptoms.Physical fatigue and mental fatigue are independent symptoms of Parkinson's disease.The associated factors of the two fatigue subtypes are different,physical fatigue is mainly related to the severity of motor symptoms,while mental fatigue is more affected by emotional factors.

关 键 词：帕金森病 疲劳 躯体疲劳 精神疲劳 临床特点 相关因素 

分 类 号：R742.5[医药卫生—神经病学与精神病学]