进行性核上性麻痹患者生活质量相关分析  

Associated factors for quality of life in patients with progressive supranuclear palsy

作　　者：陈德智[1] 欧汝威 魏倩倩[1] 侯炎冰 张灵语 刘坤成 蒋政 林隽羽 刘焦 杨天米 杨静[1] 商慧芳[1] CHEN De-zhi;OU Ru-wei;WEI Qian-qian;HOU Yan-bing;ZHANG Ling-yu;LIU Kun-cheng;JIANG Zheng;LIN Jun-yu;LIU Jiao;YANG Tian-mi;YANG Jing;SHANG Hui-fang(Department of Neurology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院神经内科,成都610041

出　　处：《中国现代神经疾病杂志》2021年第5期411-415,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：四川大学华西医院学科卓越发展1·3·5工程项目(项目编号:ZYJC18038)。

摘　　要：目的探讨进行性核上性麻痹患者生活质量的相关因素。方法连续纳入2012年1月至2019年12月共218例进行性核上性麻痹患者,采集其社会人口学和临床资料,采用39项帕金森病调查表(PDQ-39)评估生活质量,进行性核上性麻痹评价量表(PSPRS)评估运动症状和非运动症状,非运动症状量表(NMSS)评估非运动症状,汉密尔顿抑郁量表24项(HAMD-24)、汉密尔顿焦虑量表(HAMA)和里尔淡漠评定量表(LARS)评估情绪,额叶功能评价量表(FAB)评估额叶功能,蒙特利尔认知评价量表(MoCA)评估认知功能。对PDQ-39评分与社会人口学和各项量表评分行相关分析以及线性数量关系的验证。结果相关分析显示,PDQ-39评分与病程(r=0.301,P=0.000)、查尔森合并症指数(CCI)评分(r=0.147,P=0.031)、左旋多巴日等效剂量(r=0.225,P=0.001)、PSPRS评分(r=0.551,P=0.000)、NMSS评分(r=0.484,P=0.000)、HAMD-24评分(r=0.515,P=0.000)、HAMA评分(r=0.439,P=0.000)和LARS评分(r=0.476,P=0.000)呈正相关,而与FAB评分(r=-0.325,P=0.000)和MoCA评分(r=-0.355,P=0.000)呈负相关。多因素线性逐步回归分析显示,女性(P=0.021)、病程(P=0.026)、左旋多巴日等效剂量(P=0.008),以及PSPRS评分(P=0.000)、NMSS评分(P=0.002)、HAMD-24评分(P=0.004)和LARS评分(P=0.000)均与PDQ-39评分存在线性回归关系。结论女性、长病程、高左旋多巴日等效剂量以及严重的运动症状和非运动症状均与进行性核上性麻痹患者生活质量存在线性回归关系,应引起临床医师的高度重视。Objective To explore the associated factors for quality of life in patients with progressive supranuclear palsy (PSP).Methods A total of 218 PSP patients were included from January2012 to December 2019.Demographic and clinical data were collected.The quality of life was evaluated by the 39-Item Parkinson’s disease Questionnaire (PDQ-39).The Progressive Supranuclear Palsy Rating Scale (PSPRS) was used to assess the severity of PSP related motor and non-motor symptoms,while the NonMotor Symptoms Scale (NMSS) was used to elevate the non-motor symptoms,Hamilton Depression Rating Scale-24 (HAMD-24),Hamilton Anxiety Rating Scale (HAMA),Lille Apathy Rating Scale (LARS),Frontal Assessment Battery (FAB),and Montreal Cognitive Assessment (MoCA) were used.The Pearson and partial correlation followed by the multiple linear regression were used to explore the correlates of the PDQ-39score.Results Correlation analysis indicated that the PDQ-39 score was positively correlated with disease duration (r=0.301,P=0.000),Charlson Comorbidity Index (CCI;r=0.147,P=0.031),levodopa equivalent daily dose (LEDD;r=0.225,P=0.001),and scores for the PSPRS (r=0.551,P=0.000),NMSS (r=0.484,P=0.000),HAMD-24 (r=0.515,P=0.000),HAMA (r=0.439,P=0.000) and LARS (r=0.476,P=0.000),but was negatively correlated with scores of FAB (r=-0.325,P=0.000) and MoCA (r=-0.355,P=0.000).Multiple linear stepwise regression model indicated that the PDQ-39 score was significantly associated with female (P=0.021),longer disease duration (P=0.026),higher LEDD (P=0.008),higher PSPRS score (P=0.000),higher NMSS score (P=0.002),higher HAMD-24 score (PC=0.004),and higher LARS score (P=0.000).onclusions Female,longer disease duration,higher LEDD,and more severe motor and nonmotor symptoms contribute to the reduced quality of life in patients with PSP.Our study is beneficial to the clinical management of patients with PSP.

关 键 词：核上麻痹 进行性 生活质量 线性模型 

分 类 号：R742.5[医药卫生—神经病学与精神病学]