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目的探讨早期帕金森病患者非运动性症状与健康相关生活质量的关系,以及健康相关生活质量的影响因素。方法391例原发性帕金森病患者,采用美国国立卫生研究院流行病学研究中心抑郁量表(CES-D)、匹兹堡睡眠质量指数(PSQI)、疲劳量表(FSS)、阿尔茨海默病评价量表-认知分量表(ADAS-Cog)和便秘量表(CSS)评价其抑郁、睡眠障碍、疲劳、认知障碍和便秘程度,简化36医疗结局研究量表(SF-36)评价其健康相关生活质量。结果391例患者中,抑郁、睡眠障碍、疲劳、记忆障碍和便秘者分别占37.34%(146/391)、54.73%(214/391)、40.15%(157/391)、34.78%(136/391)和46.55%(182/391)。抑郁症状者与无抑郁症状者(t=18.469,P=0.000)、睡眠障碍者与无睡眠障碍者(t=7.411,P=0.000)、疲劳者与无疲劳者(t=3.992,P=0.000)比较,SF-36总评分差异具有统计学意义;而记忆障碍者与无记忆障碍者(t=1.234,P=0.221)、便秘者与无便秘者(t=2.032,P=0.051)比较,SF-36总评分差异无统计学意义。将CES-D评分、PSQI评分和FSS评分引入回归方程,R2值由0.277增至0.649,提示SF-36总评分可被预测的部分由27.70%增至64.90%;CES-D评分不仅对SF-36总评分有预测价值,而且对8个维度评分均有预测价值(P<0.05)。结论早期帕金森病患者普遍存在非运动性症状,其中抑郁、睡眠障碍、疲劳是导致健康相关生活质量恶化的主要原因。抑郁全面影响患者健康相关生活质量,是早期帕金森病患者健康相关生活质量恶化的最强预测因素。
Objective To investigate the relationship between non-motor symptoms and health-related quality of life in patients with early Parkinson’s disease, and the influencing factors of health-related quality of life. Methods 391 patients with primary Parkinson’s disease were enrolled in this study. The depression scale (CES-D), Pittsburgh Sleep Quality Index (PSQI), fatigue scale (FSS), Alzheimer’s Sickness, sleep disorders, fatigue, cognitive impairment and constipation were assessed by the ADAS-Cog and CSS scales to simplify the evaluation of the 36-care Outcomes Scale (SF-36) Its health-related quality of life. Results Among the 391 patients, 37.34% (146/391), 54.73% (214/391), 40.15% (157/391), 34.78% (136/391) patients had depression, sleep disturbance, memory impairment and constipation ) And 46.55% (182/391). Patients with depression and without depression (t = 18.469, P = 0.000), those with or without sleep disturbance (t = 7.411, P = 0.000) (T = 1.234, P = 0.221), those with constipation and those without constipation (t = 2.032, P = 0.051) were significantly higher than those without constipation SF-36 total score difference was not statistically significant. CES-D score, PSQI score and FSS score were introduced into the regression equation. The R2 value increased from 0.277 to 0.649, which indicated that the predictable part of SF-36 total score increased from 27.70% to 64.90%. CES- 36 total score has predictive value, and all of the eight dimensions have predictive value (P <0.05). Conclusions There is a general non-motor symptom in patients with early-stage Parkinson’s disease. Depression, sleep disturbance and fatigue are the main reasons leading to the deterioration of health-related quality of life. Depression affects patients’ overall health-related quality of life and is the strongest predictor of health-related deterioration in quality of life in patients with Parkinson’s disease.