帕金森病相关性疼痛的相关因素及其对生活质量的影响

Relevant factors of Parkinson’s disease related pain and its impact on the quality of life

目的探讨帕金森病(PD)相关性疼痛的相关因素及其对生活质量的影响。方法根据是否伴有疼痛将120例PD患者分为疼痛组(49例)和非疼痛组(71例)。采用PD统一评分量表(UPDRS)和Hoehn-Yahr(H-Y)分级评估患者的严重程度,采用PD生活质量量表-39(PDQ-39)测评其生活质量,用数字评分法(NRS)评估疼痛组患者疼痛程度。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和MMSE评价患者的焦虑、抑郁及认知情况。结果与无疼痛组比较,疼痛组H-Y分期及UPDRSⅠ、UPDRSⅢ服药后(med-on)、UPDRSⅢ服药前(med-off)、PDQ-39、HAMA、HAMD评分均显著升高(P<0.05~0.01)。Spearman相关分析显示,NRS评分与H-Y分级及UPDRSⅠ、UPDRSⅢmed-off、UPDRSⅢmed-on、PDQ-39、HAMA、HAMD评分呈正相关(P<0.05~0.01),与年龄、发病年龄、病程、受教育年限及UPDRSⅡ、MMSE评分无相关性(均P>0.05)。线性回归分析显示,UPDRSⅡ、HAMA、NRS评分对PDQ-39有显著性影响(均P<0.01)。结论 PD相关性疼痛可能与精神活动、运动症状、焦虑抑郁相关。PD相关性疼痛是影响PD患者生活质量的独立预测因子。

Objective To explore the relevant factors for Parkinson’s disease(PD) related pain and its impact on quality of life.Methods One hundred and twenty patients with PD were divided into pain group(49 cases) and non-pain group(71 cases) according to whether they were accompanied by pain or not. Unified Parkinson’s disease rating scale(UPDRS) and Hoehn-Yahr(H-Y) were used to assess the severity of PD. The 39-item Parkinson’s disease questionnaire(PDQ-39) was used to assess the quality of life in PD patients. The level of pain was assessed with numerical rating scale(NRS). Also, the Hamilton anxiety scale(HAMA), Hamilton depression scale(HAMD) and MMSE scores were obtained separately to assessed anxiety, depression and cognition of all patients. Results Compared with those in non-pain group, H-Y staging and UPDRSⅠ, UPDRSⅢ med-on, UPDRSⅢ med-off, PDQ-39, HAMA, and HAMD scores in pain group were significantly higher(P<0.05-0.01). Spearman correlation analysis showed that NRS score was positively correlated with H-Y grade and UPDRSⅠ, UPDRSⅢ med-off, UPDRSⅢ med-on, PDQ-39, HAMA and HAMD score(P<0.05-0.01). However, NRS score was not associated with age, age of onset, duration of disease, years of schooling, UPDRSⅡ and MMSE score(all P>0.05). Linear Regression analysis found that NRS score, UPDRSⅡ, HAMA have significant effect on PDQ-39 by descending order(all P<0.01). Conclusions PD related pain may be associated with factors such as mental activity, motor symptom, anxiety and depression. PD related pain is an independent predictor of quality of life in patients with PD.