左旋多巴对老年帕金森病患者疗效的影响因素分析  

Analysis of influencing factors of Levodopa on the efficacy of elderly Parkinson's disease patients

作　　者：郑晓芬 罗雪文 ZHENG Xiaofen;LUOXuewen(Department of Gerontology,Longyan Hospital of Traditional Chinese Medicine,Fujian Province,Longyan 364000,China)

机构地区：[1]福建省龙岩市中医院老年医学科,福建龙岩364000

出　　处：《中国当代医药》2024年第30期41-44,共4页China Modern Medicine

摘　　要：目的 分析左旋多巴对老年帕金森病患者疗效的影响因素。方法 回顾性分析2022年9月至2023年9月龙岩市中医院采用左旋多巴治疗的91例老年帕金森病患者的临床资料,依据治疗效果,将91例患者分为治疗有效组与治疗无效组,统计并分析两组患者一般资料及各项评分[蒙特利尔认知评估量表(MoCA)、心理一致感量表(SOC-13)、慢性病自我效能感量表(CDSES)],采用logistic回归模型进行多因素分析,分析影响左旋多巴治疗老年帕金森病患者临床效果的因素。结果 经左旋多巴治疗后,91例老年帕金森病患者有效78例(85.71%),无效13例(14.29%)。单因素分析结果显示,治疗无效组与治疗有效组的性别、年龄、病程、学历、户籍所在地、帕金森病分期方面比较,差异无统计学意义(P>0.05);两组在合并高血压史、合并脑梗死史、用药情况、MoCA评分、SOC-13评分、CDSES评分方面比较,差异有统计学意义(P<0.05)。多因素logistic回归模型分析结果显示,合并高血压史(β=1.807,OR=6.095,95%CI:1.267~29.319)、合并脑梗死史(β=1.391,OR=4.018,95%CI:1.134~14.241)、用药不规范(β=1.674,OR=5.333,95%CI:1.357~20.956)是影响左旋多巴治疗老年帕金森病患者临床效果的独立危险因素,而认知功能(β=-3.280,OR=0.038,95%CI:0.005~0.266)、心理一致感(β=-1.535,OR=0.215,95%CI:0.091~0.509)、自我效能感(β=-1.727,OR=0.178,95%CI:0.049~0.639)是其独立保护因素,差异有统计学意义(P<0.05)。结论 合并高血压史、合并脑梗死史、用药不规范等是影响老年帕金森病患者临床效果的重要因素。临床采用左旋多巴治疗时,应制定前瞻性干预方案,改善患者认知功能,并从心理一致感及自我效能感方面入手,综合提升治疗效果。Objective To analyze the influencing factors of Levodopa on the efficacy of elderly Parkinson's disease patients.Methods The clinical data of 91 elderly patients with Parkinson's disease who were treated with Levodopa in Longyan Hos-pital of Traditional Chinese Medicine from September 2022 to September 2023 were retrospectively analyzed.According to the therapeutic effect,91 patients were divided into effective treatment group and ineffective treatment group.General data and scores of the two groups of patients(montreal cognitive assessment[MoCA],sense of coherence scale-13[SOC-13],chronic disease self-efficacy scale[CDSES]) were statistically analyzed.Multivariate analysis was carried out by logistic regression model to analyze the factors affecting the clinical effect of Levodopa on elderly patients with Parkinson's disease.Results After Levodopa treatment,78 cases(85.71%)of 91 elderly patients with Parkinson's disease were effective,13 cases(14.29%)were ineffective.Univariate analysis showed that there were no significant differences in gender,age,course of disease,education,household registration and Parkinson's disease stage between the treatment ineffective group and the treatment effective group(P>0.05).There were statistically significant dfferences in history of hypertension,history of cerebral infarction,drug use,MoCA score,SOC-13 score and CDSES score between the two groups(P<0.05).Multivariate logistic regression model analysis results indicated that the patients had history of hypertension(β=1.807,OR=6.095,95%Cl:1.267-29.319),history of cerebral infarction(β=1.391,0R=4.018,95%Cl:1.134-14.241),and irregular medication(β=1.674,OR=5.333,95%CI:1.357-20.956)were independent risk factors affecting the clinical effect of Levodopa in el-derly patients with Parkinson's disease,while cognitive function(β=-3.280,0R=0.038,95%CI:0.005-0.266)and psycho-logical congruence(β=-1.535,OR=0.215,95%CI:0.091-0.509)and self-efficacy(β=-1.727,OR=0.178,95%CI:0.049-0.639)were independent protective factors,and the diffe

关 键 词：左旋多巴 老年帕金森病 影响因素 自我效能感 

分 类 号：R752.5[医药卫生—皮肤病学与性病学]