帕金森病患者跌倒恐惧的多因素分析

Influencing factors for fear of falling in Parkinson's disease patients

目的研究帕金森病(Parkinson's disease,PD)患者跌倒恐惧(fear of falling,FOF)的影响因素。方法选择同济大学附属同济医院门诊就诊的PD患者115例,有跌倒史患者46例,无跌倒史患者69例。采用活动平衡信心(activities-specific balance confidence,ABC)评分评估患者FOF程度,采用Berg平衡量表(Berg balance scale,BBS)评定患者平衡功能,统一PD评定量表运动部分(unified Parkinson's disease rating scale-Ⅲ,UPDRS-Ⅲ)评定患者运动功能,统一PD评定量表姿势与步态部分(posture and gait subscores of the UPDRS,UPDRS-PG)评估患者姿势与步态损伤。用相关分析和逐步多元回归分析FOF的影响因素。结果有跌倒史与无跌倒史患者ABC评分比较,差异有统计学意义[(65.7±24.2)分vs(71.7±18.4)分,P<0.05]。逐步多元回归分析显示,有≥2次跌倒史、UPDRS-PG和BBS评分是FOF的影响因素(P<0.05,P<0.01),UPDRS-Ⅲ评分不是FOF的影响因素(P>0.05)。结论多次跌倒史、平衡功能障碍、姿势步态损伤是影响PD患者FOF的主要因素。

Objective To study the influencing factors for fear of falling（FOF）in Parkinson＇s disease（PD）patients.Methods One hundred and fifteen PD patients（46 with a falling history）who visited our outpatient department were included in this study.Their FOF was assessed according to the activities specific balance confidence（ABC）,their balance function was scored according to the Berg Balance Scale（BBS）,their motor function was tested according to the Unified PD Rating ScaleⅢ（UPDRS-Ⅲ）,their posture and gait were assessed according to the posture and gait subscores of UPDRS（UPDRS-PG）.The influencing factors for FOF were analyzed by correlation analysis and multivariate regression analysis respectively.Results The ABC score was significantly lower in PD patients with a falling history than in those without falling history（65.7±24.2 vs 71.7±18.4,P〈0.05）.Multivariate regression analysis showed that falling history frequency ≥2,UPDRS-PG and BBS scores were the influencing factors for FOF in PD patients（P〈0.05,P〈0.01）.However,UPDRS-Ⅲ score was not an influencing factor for FOF in PD patients（P〉0.05）.Conclusion Multiple falling history,balance function,posture and gait are the major influencing factors for FOF in PD patients.