膀胱过度活动症对帕金森病患者生活质量的影响

Effect of overactive bladder on quality of life in patients with Parkinson s disease

目的探讨膀胱过度活动症(overactive bladder,OAB)对帕金森病(Parkinson disease,PD)患者生活质量的影响。方法连续收集2020年10月至2021年8月河南省人民医院收治的PD患者136例,根据是否伴有OAB将患者分为PD伴OAB组(n=63)和PD未伴OAB组(n=73)。采用膀胱过度活动调查问卷(OABSS)评估PD患者OAB的类型及严重程度,采用国际运动障碍协会统一帕金森病评定量表第三部分(UPDRSⅢ)和Hoehn-Yahr(H-Y)分级评估患者的运动症状和疾病严重程度,同时采用匹兹堡睡眠质量指数量表(PSQI)、艾普沃斯嗜睡量表(ESS)、汉密尔顿抑郁量表-17(HAMD-17)、汉密尔顿焦虑量表-14(HAMA-14)、简易精神状态量表(MMSE)评估其非运动症状,采用PD生活质量量表-39(PDQ-39)对其生活质量进行评估。采用Pearson相关性和多元有序Logistics回归分析影响OAB严重程度的因素,采用Pearson相关性和逐步多元线性回归分析影响PD患者生活质量的因素。结果136例PD患者中OAB的发生率为46.3%,排尿障碍中以夜尿增多最常见(75.0%),其次是尿急(51.5%)、尿失禁(44.9%)、日间尿频(22.1%)。PD伴OAB组年龄、H-Y分级、左旋多巴每日等效剂量(LEDD)、UPDRSⅢ评分、HAMD-17评分、PSQI评分、ESS评分和PDQ-39评分较PD未伴OAB组高(均P<0.05)。多元有序Logistic回归分析结果显示H-Y分级、HAMA-14评分是OAB严重程度的影响因素(均P<0.05)。逐步多元线性回归分析显示,H-Y分级、ESS评分、OABSS评分、UPDRSⅢ评分、HAMD-17评分是PD患者生活质量的影响因素(均P<0.05)。结论PD患者OAB发生率较高,且OAB是影响PD患者生活质量的影响因素。

Objective To study the effect of overactive bladder(OAB)on quality of life in patients with Parkinson s disease(PD).Methods A total of 136 PD patients continuously admitted to Henan Provincial People s Hospital from October 2020 to August 2021 were in the study.According to the symptoms of overactive bladder,the patients were classified into OAB group(n=63)and non-OAB group(n=73).The type and severity of OAB in PD patients were assessed by Overactive Bladder Symptom Score(OABSS).The motor symptoms and disease severity of patients were graded by the third part of Movement Disorder Society-sponsored revision of the unified Parkinson s disease rating scale(MDS-UPDRSⅢ)and Hoehn-Yahr stages(H-Y).Furthermore,non-motor symptoms were assessed by the Pittsburgh sleep quality index(PSQI),Epworth sleepiness scale(ESS),17-item Hamilton depression rating scale(HAMD-17),14-item Hamilton anxiety rating scale(HAMA-14),and mini-mental status examination(MMSE).The quality of life of PD patients was evaluated by the 39-item Parkinson s disease questionnaire(PDQ-39).Pearson correlation and multiple ordered logistics regression were used to analyze the factors affecting the severity of OAB,and Pearson correlation and stepwise multiple linear regression were conducted to analyze the factors affecting the quality of life of PD patients.Results The incidence of OAB in PD patients was 46.3%.In addition,nocturia was the most common symptom in urination with a high incidence of 75.0%,the incidence of urgent urination,urinary incontinence,and daytime frequent urination was 51.5%,44.9%,and 22.1%,respectively.OAB group had older age,higher H-Y stages,Levodopa equivalent daily dose(LEDD),UPDRSⅢscore,HAMD-17 score,PSQI score,ESS score and PDQ-39 score than non-OAB group(P<0.05).Multiple ordered logistic regression showed that the influencing factors of OAB severity included H-Y stages and HAMA-14 score(P<0.05).Stepwise multiple linear regression analysis revealed that the factors affecting the quality of life of PD included H-Y stages,ESS,OABSS,UPDRSⅢand HAMD-17 score(P<0.05).Conclusions The incidence of OAB is high in PD patients,and OAB is a factor affecting the quality of life in PD patients.