摘要
目的探讨非运动症状对帕金森病患者早期日常生活能力变化轨迹的影响,以期帮助医护人员在临床前期为低水平日常生活能力人群实施干预措施提供参考。方法于2024年7月采用便利抽样法选择帕金森进展标志物计划中431例帕金森病患者从基线到入组后连续5年的纵向随访数据,包括日常生活能力得分、快速眼动睡眠行为筛查量表得分等。通过潜类别增长模型对日常生活能力变化轨迹进行分类,后用单因素和二元Logistic回归分析其影响因素。结果431例患者中,男260例,女171例,年龄(61.30±9.60)岁。患者基线、入组12个月、入组36个月、入组60个月的日常生活能力得分分别为(5.97±4.30)、(7.20±4.61)、(8.90±5.60)、(10.57±6.93)分。模型识别出低生活能力快速加重组(25.3%,109/431)和较低生活能力缓慢加重组(74.7%,322/431)2类变化轨迹。二元Logistic回归结果显示,淡漠(OR=0.374,95%CI 0.189~0.739)、疲劳(OR=0.261,95%CI 0.138~0.495)、宾夕法尼亚大学的气味识别测试(OR=1.039,95%CI 1.005~1.074)、快速眼动睡眠行为障碍筛查量表(OR=0.880,95%CI 0.795~0.973)及自主神经症状自评量表胃肠道得分(OR=0.724,95%CI 0.630~0.832)是帕金森病患者日常生活能力变化轨迹分类的独立影响因素(均P<0.05)。结论帕金森病患者早期日常生活能力随时间变化呈下降趋势,应重点关注有疲劳或淡漠症状、快速眼动睡眠行为障碍筛查量表和自主神经症状自评量表胃肠道得分高的患者,制订针对性护理干预方案,进而延缓疾病进程。
Objective To explore the influence of non-motor symptoms on the change trajectory of early activities of daily living in patients with Parkinson disease,and to provide a reference for medical staff to implement intervention measures for people with low levels of activities of daily living in the preclinical stage.Methods The longitudinal follow-up data of 431 patients with Parkinson disease in the Parkinson's progression Markers Initiative from baseline to five consecutive years after enrollment were selected by convenience sampling method in July 2024,including the scores of aceivities of daily living,the Rapid Eye Movement Sleep Behavioral Disorder Screening Questionnaire,etc.A latent class growth model classified change trajectory of activities of daily living,and the influencing factors were analyzed by univariate and binary Logistic regression.Results Among the 431 patients,260 were male and 171 were female,with an average age of(61.30±9.60)years.The scores of activities of daily living of the patients at baseline,12 months after enrollment,36 months after enrollment,and 60 months after enrollment were(5.97±4.30),(7.20±4.61),(8.90±5.60),and(10.57±6.93)points,respectively.The model identified two types of trajectories:rapid decline in low activities of daily living group(25.3%,109/431)and slow decline in lower activities of daily living group(74.7%,322/431).The binary Logistic regression results showed that apathy(OR=0.374,95%CI 0.189-0.739),fatigue(OR=0.261,95%CI 0.138-0.495),University of Pennsylvania Smell Identification Test(OR=1.039,95%CI 1.005-1.074),the Rapid Eye Movement Sleep Behavioral Disorder Screening Questionnaire(OR=0.880,95%CI 0.795-0.973),and the gastrointestinal score of the Scales for Outcomes in PD-Autonomic(OR=0.724,95%CI 0.630-0.832)were independent influencing factors for the classification of the change trajectory of activities of daily living in patients with Parkinson disease(all P<0.05).Conclusions Patients with Parkinson disease exhibit a decreasing trend in early activities of daily living,emphasizing the need for targeted interventions in those with fatigue,apathy,and high Rapid Eye Movement Sleep Behavioral Disorder Screening Questionnaire and Scales for Outcomes in Parkinson disease-Autonomic gastrointestinal scores to possibly decelerate disease advancement.
作者
胡苗
袁平乔
李馨妤
崔米
吴宝勤
Hu Miao;Yuan Pingqiao;Li Xinyu;Cui Mi;Wu Baoqin(School of Nursing,Guizhou Medical University,Guiyang 550000,China;Department of Neurology,Affiliated Hospital of Guizhou Medical University,Guiyang 550000,China;Department of Outpatient,Affiliated Hospital of Guizhou Medical University,Guiyang 550000,China)
出处
《中国实用护理杂志》
2025年第28期2213-2219,共7页
Chinese Journal of Practical Nursing
基金
贵州省科技计划项目(黔科合成果-LC[2023]015)。
关键词
帕金森病
非运动症状
日常生活能力
潜类别增长模型
变化轨迹
Parkinson disease
Non-motor symptoms
Activities of daily living
Latent category growth model
Trajectory of change
