疼痛对帕金森病患者生活质量的影响

Effect of pain on quality of life in Parkinson’s disease patients

目的探讨疼痛对帕金森病(Parkinson’s disease,PD)患者生活质量的影响。方法连续收集PD患者229例,根据有无疼痛将患者分为疼痛组112例和不伴疼痛组117例,采用King’s帕金森病疼痛量表(KPPS)评估患者的疼痛类型和严重程度,采用汉密尔顿抑郁量表(HAMD-17)、爱普沃思嗜睡量表(ESS)分别对抑郁和日间嗜睡进行评价,疾病严重程度采用国际帕金森和运动障碍协会修订的统一帕金森病评估量表(MDS-UPDRS)和Hoehn-Yahr(H-Y)分期进行评定,生活质量用PD生活质量量表-39(PDQ-39)进行评估,并分析疼痛对PD患者生活质量的影响。结果PD患者疼痛的发生率为48.9%,其中肌肉骨骼疼痛占75%,波动相关性疼痛为39.3%和夜间痛为28.6%;疼痛组PDQ-39得分较不伴疼痛组明显增高,差异有统计学意义(P<0.01)。多元线性回归分析显示,影响PDQ-39总分的因素从大到小依次为HAMD-17(β=0.403,P<0.01)、H-Y分期(β=0.266,P<0.01)、ESS(β=0.259,P<0.01)、疼痛(β=0.184,P<0.01)、起病年龄(β=-0.102,P<0.05)。结论肌肉骨骼疼痛是PD患者最常见的疼痛类型,其次是波动相关性疼痛和夜间痛;疼痛影响PD患者的生活质量。

Objective To study the effect of pain on the quality of life in Parkinson’s disease(PD)patients.Methods A total of 229 PD patients were continuously collected.According to whether suffer from pain,the patients were classified into pain group and non-pain group.Non-motor symptom variables were assessed by the King’s PD pain scale(KPPS)for the type and severity of the pain,Hamilton depression scale-17(HAMD-17)for depression symptoms and the Epworth sleepiness scale(ESS)for daytime sleepiness.The severity of the disease were measured by the third part of movement disorder society-sponsored revision of the unified Parkinson’s disease rating scale(MDS-UPDRSⅢ)and Hoehn-Yahr scale.And the quality of life was measured by the 39 item Parkinson’s disease questionnaire(PDQ-39)and then analyze the effect of pain on the quality of life.Results The prevalence of pain in PD was 48.9%.Musculoskeletal pain accounted for 75%of all,fluctuation-related pain was 39.3%and nocturnal pain was 28.6%.The PDQ-39 scores were significantly higher in pain group than those in non-pain group(P<0.01).Multiple linear regression analysis revealed that the main factors affecting PDQ-39 total score were HAMD-17(β=0.403,P<0.01),H-Y scale(β=0.266,P<0.01),ESS(β=0.259,P<0.01),pain(β=0.184,P<0.01),age of onset(β=-0.102,P<0.05).Conclusion Musculoskeletal pain is the most common type of pain in PD patients,followed by fluctuation-related pain and nocturnal pain.The pain affect the quality of life in PD patients.