帕金森病患者非运动症状对其生活质量的影响

Effects of non-motor symptoms on health-related quality of life in Parkinson＇s disease

目的 探讨非运动症状对帕金森病（PD）患者健康生活质量的影响.方法 对2011年9月至2013年6月于苏州市中医医院神经内科门诊和病房接受治疗的128例原发性PD患者采用问卷调查法,应用帕金森病非运动症状评定量表（NMSS）调查PD患者NMS的发生率和水平;应用帕金森病生活质量调查表（PDQ39）评价PD患者健康相关生活质量的水平.结果 本组PD患者NMS的总体发生率为100％,得分为47 ～229分,平均（124 ±48）分.PD患者所有NMS中发生率最高的症状为“便秘”,NMS的发生与年龄（r=0.226,P＜0.05）、H-Y分期（r=0.442,P＜0.05）、病程（r=0.223,P ＜0.05）呈正相关,而与性别无相关性（r=0.085,P＞0.05）;本组PD患者PDQ39的总体水平为10 ～76分,平均（44±16）分.得分最高的4个维度分别为：生活自理能力（60±15）分、运动功能（49±21）分、情感状态（49±28）分、病耻感（48±46）分.女性（x2=-1.821,P＜0.05）、老年和无伴侣（x2=-1.512,P＜0.05）的患者在健康相关生活质量比其他患者差.PD患者的病程（r=0.260,P＜0.05）、疾病严重程度（r=0.259,P＜0.05）的得分与健康相关生活质量的总分呈正相关,NMSS总分与健康相关生活质量总分呈正相关（r =0.686,P＜0.01）.结论 NMS普遍存在于帕金森病患者当中,是影响帕金森病患者健康相关生活质量最主要的因素.

Objective To explore the effects of nom-motor symptoms （NMS） on health-related quality of life （HRQOL） in Parkinson＇s disease （PD） patients. Methods By convenient sampling, 128 PD patients were recruited. NMS was assessed by the non-motor symptoms scale for PD （NMSS） and HRQOL by the 39-item PD Questionnaire （ PDQ39 ）. Results All PD Patients （ !00% ） had NMS with a general score of（ 124 -±48）. Among these NMS, constipation was ranked the highest and the general level of NMS was significantly positively associated with age （ r = O. 226, P 〈 0. 05 ） , Hoehn-Yahr staging （ r = 0. 442, P 〈 O. 05 ） and disease course （ r = 0. 223, P 〈 O. 05 ）. However there was no correlation with gender （ r = 0. 085, P 〈0. 05）. For PD patients, HRQOL became impaired with a general score of（44 -± 16）. Activities of daily living （ 60 ± 15 ） , mobility （49 ± 21 ） , emotional well-being （ 49 ± 28 ） and stigma （ 48 ± 46 ） were the most seriously affected. Females（ X2 =- 1. 821 P 〈 0. 05 ） and senile bereaved patients（ X2 = - 1. 512, P 〈 0. 05 ） had significantly lower HRQOL than that of others. For PD patients, the general level of HRQOL was significantly positively associated with disease course （ r = 0. 260, P 〈 0, 05 ） and severity （ r = 0. 259, P 〈 0. 05 ）. The general level of HRQOL was significantly positively associated with the general level of NMS （ r = O. 686, P 〈 0. 01 ）. Conclusion Non-motor symptoms （NMS） arc quite common in PD patients. For PD patients, NMS has a more negative impact on HRQOL than other symptoms.