STN-DBS术联合药物对帕金森患者认知功能、生活质量及UA水平的影响

Effects of STN-DBS combined with drugs on cognitive function,quality of life and UA level in patients with Parkinson′s disease

目的研究丘脑底核深部脑电刺激术(STN-DBS)对帕金森患者认知功能、生活质量、血尿酸(UA)水平的影响。方法选取2016年1月~2019年5月泰州市人民医院和上海瑞金医院神经外科收治的60例帕金森患者为研究对象,对照组30例给予药物治疗,观察组在对照组的基础上给予STN-DBS术治疗。连续治疗3个月,采用全自动生化分析仪器测定患者UA水平,比较两组患者临床疗效、帕金森病生活质量量表(PDQUALIF)评分、蒙特利尔认知评估量表(MoCA)评分情况。结果与对照组比较,观察组患者治疗6周后PDQUALIF评分、UA水平差异均无统计学意义(P>0.05);观察组患者治疗12周后总有效率升高,PDQUALIF评分和UA水平均降低,差异有统计学意义(P<0.05);观察组患者治疗6、12个月后认知功能差异无统计学意义(P>0.05)。结论STN-DBS术联合药物治疗帕金森可降低患者UA水平,改善生活质量,但对认知功能的影响较小。

Objective To study the effect of deep brain stimulation of the subthalamic nucleus(STN-DBS)on cognitive function,quality of life and blood uric acid(UA)in Parkinson patients.Methods From January 2016 to May 2019,60 Parkinson′s patients were treated in neurosurgery at Taizhou People′s Hospital and Shanghai Ruijin Hospital as observation group,while 30 patients were treated with drugs as control group.STN-DBS treatment was given in the observation group on the basis of the control group.For three months,automatic biochemical analysis instrument was used to determine the UA level of patients,the clinical efficacy,the quality of life scale(PDQUALIF)score of Parkinson′s disease and the montreal cognitive assessment scale(MoCA)score were compared between the two groups.Results Compared with the control group,there was no significant difference in PDQUALIF score and UA level in the observation group after 6 weeks of treatment(P>0.05);after 12 weeks of treatment,the total effective rate of the observation group was increased,the PDQUALIF score and UA level were decreased(P<0.05);there was no significant difference in the cognitive function of patients in the observation group after 6 and 12 months of treatment(P>0.05).There was no significant difference in cognitive function score between the two groups before the treatment,6 months and 12 months after the treatment(P>0.05).Conclusion STN-DBS combined with drug therapy for Parkinson′s disease can reduce the UA level and improve the quality of life of patients,but it has little effect on cognitive function.