帕金森病疲劳症状的危险因素

Risk Factors of Fatigue Symptoms in Parkinson’s Disease

目的 分析帕金森病(PD)患者疲劳的危险因素。方法 收集并分析2019年11月至2021年7月于郑州大学第一附属医院神经内科住院并确诊的120例原发性PD患者的临床资料,根据疲劳严重程度量表(FSS)将入选患者划分为疲劳组与非疲劳组,收集记录被纳入患者的人口学资料、实验室指标资料及临床资料,进行组间差异比较,采用多因素logistic回归分析筛选出PD疲劳的独立危险因素,并绘制受试者工作特征(ROC)曲线,以评估筛选出的独立危险因素预测疲劳的价值。结果 与非疲劳组患者相比,疲劳组患者病程更长,每日左旋多巴等效剂量、统一帕金森病量表第三部分评分、Hoehn-Yahr分级及爱泼沃斯恩嗜睡量表评分更高,抑郁及认知障碍情况更差,血C反应蛋白(CRP)及血同型半胱氨酸(Hcy)水平更高,生活质量更低(P<0.05),而两组患者在性别、年龄、发病年龄、受教育程度、焦虑方面差异无统计学意义(P>0.05);logistic回归分析显示日间嗜睡程度重、CRP水平高及生活质量低是PD患者发生疲劳的独立危险因素;ROC曲线分析显示日间嗜睡程度重、CRP水平高及生活质量低对PD患者发生疲劳具有预测价值。结论 日间嗜睡程度重、CRP水平高及生活质量更低的PD患者需要警惕疲劳的发生。

Objective To investigate the risk factors of fatigue symptoms in Parkinson’s disease(PD).Methods Clinical data of 120 patients with primary PD diagnosed in the ward of Neurology Department of the First Affiliated Hospital of Zhengzhou University from November 2019 to July 2021 were collected and analyzed.Patients were divided into fatigue group and non-fatigue group according to fatigue severity scale(FSS).Demographic data,laboratory indicators and clinical data of the enrolled patients were collected and recorded to compare the differences between the groups.Logistic regression analysis was used to screen out the independent risk factors for PD fatigue,and receiver operating characteristic(ROC) curve was used to evaluate the value of screened independent risk factors in predicting fatigue.Results Compared with the non-fatigue group,the fatigue group had longer course of disease,higher total levodopa equipment daily dose,unified Parkinson’s disease rating scale Ⅲ score,Hoehn-Yahr stage and Epworth sleepiness scale score,worse depression and cognitive dysfunction,higher C-reactive protein(CRP) and homocysteine(Hcy) levels,and lower quality of life(P0.05).The logistic regression analysis showed that heavy daytime sleepiness,high CRP level and low quality of life were independent risk factors for fatigue in PD patients.The ROC curve analysis showed that heavy daytime sleepiness,high CRP level and low quality of life had predictive value for fatigue in PD patients.Conclusion PD patients with heavy daytime sleepiness,high CRP level and lower quality of life should be alert to the occurrence of fatigue.