帕金森病患者日常生活活动能力的主要影响因素

Study on the factors influencing ADL in patients with Parkinson′ s disease

目的:探讨影响帕金森病(PD)患者日常生活活动能力的主要因素。方法:采用PD统一评分量表第2部分(UPDRSⅡ)对107例PD患者的ADL能力进行评估,并选用Hoehn-Yahr分级帕金森病统一评分量表-Ⅲ(UPDRS-Ⅲ)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、简易精神状态量表(MMSE)、蒙特利尔认知评估(MOCA)、睡眠量表及Epworth嗜睡评分量表(ESS)等量表作为评估患者运动功能、焦虑、抑郁、认知、记忆、睡眠状况等的指标。同时结合年龄、性别、发病时间、目前左旋多巴用量等可能影响患者ADL能力的因素评估上述指标对PD患者ADL影响的程度。结果:逐步法多元线性回归分析提示:影响PD患者ADL能力的主要因素是UPDRS-Ⅲ、ESS、病程及受教育程度。结论:运动功能及心理因素是影响PD患者ADL能力的主要因素。因此,在治疗过程应联合药物治疗和康复治疗,以提高PD患者的ADL能力。

Objective： To identify the essential factors which may influence activities of daily living （ADL） in patiens with Parkinson＇s disease （PD）. Method： The ADL in 107 patients with PD were assessed by UPDRS Ⅱ. Meanwhile, motor function, anxiety,depression, cognition, memory and sleep state were measured by Hoehn-Yahr stage, unified Parkinson＇s disease rating score Ⅲ（UPDRS-Ⅲ）, Hamilton anxiety scale（HAMA）, Hamilton depression scale（HAMD）, mini-mental state examination（MMSE）, Montreal cognition assess（MOCA）. The factors which may affect ADL in patients,such as age,gender,onset and drugs were also investigated. Result： Multiple stepwise regression analysis showed that the main factors involved in ADL in patients with PD were UPDRS-Ⅲ ,ESS, onset and level of education. Conclusion： The main factors influencing ADL in PD patiens were motor function and mental factors. So drug treatment and rehabilitation treatment should be combined to improve ADL in patiens with PD.