老年帕金森病患者平衡功能变化的影响因素分析

Analysis of influencing factors of balance function changes in elderly patients with Parkinson s disease

目的分析老年帕金森病(PD)患者平衡功能变化的影响因素。方法回顾性分析2019年7月12日—2021年6月13日于四川大学华西医院就诊的155例PD患者的临床资料,根据Hoehn-Yahr分期量表将其分为PD早期组、PD中期组及PD晚期组。比较3组平衡功能;采用二元Logistics回归分析探究PD患者发生平衡功能障碍的危险因素。结果PD早期、中期及晚期组患者随着H&Y分期进展,3组的TUGT用时显著延长,步速及BBS评分显著降低,UPDRS-Ⅲ评分和步态障碍发生率明显升高(均P<0.05);眼睑活动障碍、H&Y分期、饮酒、病程、尿酸值是影响患者出现平衡障碍的单因素(均P<0.05);二元Logistics回归分析显示,H&Y 45期、眼睑活动障碍、低血尿酸水平(<200μmol/L)为引发平衡功能障碍的独立危险因素。平衡功能障碍组及平衡功能正常组中PD早期、中期、晚期亚组患者的血尿酸水平呈降低趋势,不同亚组间比较差异有统计学意义(均P<0.05);且平衡功能障碍组PD早期、中期及晚期组的血尿酸水平均低于平衡功能正常组(均P<0.05)。结论老年PD患者随着H&Y分期进展其步速变缓,运动平衡能力显著下降;眼睑活动障碍和低血尿酸水平均可能导致PD患者步态障碍发生风险升高。

Objective To explore the influencing factors of balance function in elderly patients with Parkinson s disease(PD).Methods The clinical data of 155 patients with PD treated in West China Hospital,Sichuan University between July 12,2019 and June 13,2021 were retrospectively analyzed.According to the Hoehn-Yahr(H&Y)Staging Scale,the patients were divided into early PD group,middle PD group and late PD group.The balance function of the three groups was compared.Binary logistics regression analysis was used to explore the risk factors of balance dysfunction in PD patients.Results With the progression of H&Y staging,TUGT time of early PD group,middle PD group and late PD group was significantly prolonged,gait speed and BBS score were significantly decreased,and UPDRS-Ⅲscore and incidence of gait disturbance were significantly increased(all P<0.05).Eyelid movement disorder,H&Y staging,alcohol consumption,course of disease and uric acid level were the single factors affecting the development of balance disorder(all P<0.05).Binary logistics regression analysis showed that H&Y staging 4-5,eyelid movement disorder and low blood uric acid level(<200μmol/L)were independent risk factors for balance dysfunction.In the balance dysfunction group and the balance function normal group,the blood uric acid levels of patients in the early PD subgroup,middle PD subgroup,and late PD subgroup showed a decreasing trend.There was statistical significance among different subgroups(all P<0.05),and the blood uric acid levels of the early PD subgroup,middle PD subgroup,and late PD subgroup in the balance dysfunction group were lower than those in the normal balance function group(all P<0.05).Conclusion With the progression of H&Y staging,elderly patients with PD have slow gait speed and their motor balance ability significantly decreases.In addition,eyelid movement disorders and low blood uric acid levels may increase the risk of gait disorders in PD patients.