摘要
目的随访观察帕金森病（PD）非运动症状的发生、发展及变化情况，研究其对患者生活质量的影响。方法应用统一PD评分量表（UPDRS）第Ⅲ部分和第Ⅳ部分、PD非运动症状30问卷、PD生活质量问卷（PDQ-39）等量表，在基线和3年随访末对87例原发性PD患者进行评估，采用配对t检验、卡方检验、Spearman等级相关分析及分层回归分析等对各项数据进行统计。结果随着疾病的进展，基线和3年随访末比较，患者的UPDRSⅢ评分由（22．21±11．31）分升至（30．49±11．68）分、UPDRSIV评分从（1．00±1．54）分到（2．94±3．12）分，非运动症状评分由（7．98±3．96）分至（12．35±5．12）分，PDQ．39评分由（28．11±22．88）分升至（36．65±26．95）分，均明显升高（t=-5．54、-5．75、-6．46、-5．29，均P=0．000）。运动症状与非运动症状的加重均对生活质量的下降有影响。发生率较高的非运动症状如便秘、记忆障碍、夜尿等症状和发生率居中的抑郁焦虑症状在疾病早期就持续存在，而疼痛、多汗等非特异性症状（△R^2=21．6％），流涎、排便不尽感等消化系统症状（△R^2：23．4％）在随访过程中发生率明显上升，是导致随访中生活质量下降的主要原因。结论PD非运动症状在疾病早期就出现，随着病程延长无论运动还是非运动症状均加重，生活质量下降。
Objective To assess the development, progression and change of nonmotor symptoms in patients with Parkinson＇ s disease and its impact on patients＇ quality of life. Methods Eighty-seven consecutive patients with idiopathic Parkinson＇ s disease were studied. Parkinsonian status was assessed at baseline and 3 years follow-up using Unified Parkinson＇ s Disease Rating Scale （UPDRS） part Ⅲ ＆ Ⅳ, Nonmotor Symptoms Questionnaire （NMSQuset）, Parkinson-related quality of life （PDQ） scales. Paired t- test, Chi-square test, Spearman rank order correlation and hierarchical regression of the major statistical procedures were employed. Results At 3 years follow-up, compared to baseline, the UPDRS m score （22. 21 ± 11.31 vs 30. 49 ± 11.68）, UPDRS Ⅳ score（ 1.00 ± 1.54 vs 2. 94 ±3. 12）, NMS score （7.98 ± 3.96 vs 12. 35± 5.12） and PDQ score （28.11 ± 22. 88 vs 36.65 ± 26. 95） were significantly higher （t= -5.54, -5.75, -6.46, -5.29,all P =0.000, respectively）. The aggravation of motor and nonmotor symptoms caused the decline of quality of life. The prevalence of constipation, problem of remembering thing, nocturia ranked tops, and depression, and anxiety were still in the middle, compared with baseline. The prevalence of pains, sweating, dribbling, sense of incomplete emptying etc were significantly increased during the follow-up, △R^2 were 21.6% and 23.4% respectively, resulting in the deterioration of quality of life. Conclusions PD nonmotor symptoms appear from the early stage. The motor and nonmotor symptoms aggravate over time.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2012年第6期364-368,共5页
Chinese Journal of Neurology
基金
国家自然科学基金资助项目（81071025,81171203）
上海市科技委员会项目资助（11nm0503300,11410708900）
上海市教育委员会科研创新重点项目资助（10ZZ72）
上海市卫生局青年项目资助（2011-2013）
关键词
帕金森病
非运动症状
随访研究
生活质量
Parkinson disease
Nonmotor symptom
Follow-up
Quality of life
