帕金森病剂末现象危险因素的病例对照分析

A Case-Control Study on Risk Factors of Dose Wearing off in Parkinson's Disease

目的分析帕金森病剂末现象的危险因素。方法选取2016年1月~12月于本院就诊的155例帕金森病患者,利用剂末现象调查问卷对剂末现象(WO)进行评测后分组,对各组的临床参数与治疗参数差异进行对比。结果 155例帕金森病患者,WOQ-9量表评测WOQ-9(﹢)性122例,占比78.71%。122例WOQ-9(﹢)性符合临床定义WO(﹢)64例,占比52.46%。WOQ-9(﹢)组发病年龄比WOQ-9(﹣)偏小,病程更长,左旋多巴最大日剂量也更大,且累计用药时间亦更长,具有统计学差异(P<0.01)。与WO(﹣)组患者相比,WO(﹢)组患者的病程更长,H-Y分级更高,运动功能与强直评分更高,左旋多巴最大日剂量更大,单位体质量用量更大,累计用药时间更长(P<0.01),左旋多巴在单位体质量下的用量是WO最主要的危险因素。结论 WO的发生可能与服用左旋多巴制剂及PD进展相关,而单位体质量下的左旋多巴用量是WO最主要的危险因素。

Objective To analyze the risk factors of dose wearing off in Parkinson’s disease. Methods One hundred and fifty-five cases of patients with Parkinson’s disease from January 2016 to December 2016 in our hospital were collected, dose wearing off questionnaire on the dose wearing off（WO） were measured after grouping. The clinical parameters and treatment parameters of each group were compared. Results In 155 patients with Parkinson’s disease, 122 patients were positive for WOQ-9 by WOQ-9 scale, accounting for 78.71%. 122 cases of WOQ-9 were positive, consisting with the clinical definition of WO positive in 64 cases, accounting for 52.46%. The onset age of WOQ-9 positive group was smaller than that of WOQ-9 negative group, the course of disease was longer, the maximum daily dose of levodopa was greater, and the cumulative medication time was longer, with statistical difference（P 〈 0.01）. Compared with WO negative group, WO positive group of patients had longer duration, higher H-Y class, and higher motor function and rigidity score, the maximum daily dose of levodopa, a greater amount of body weight, a longer total treatment time（P 〈 0.01）. The dosage of levodopa in unit body mass was the most important risk factor for WO. Conclusion The occurrence of WO might be related to levodopa administration and PD progression, while the dosage of levodopa under unit body mass was the most important risk factor for WO.