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投稿时间：2017-06-20 网络发布日期：2018-03-08
投稿时间：2017-06-20 网络发布日期：2018-03-08
中文摘要: 目的 探讨帕金森病患者跌倒恐惧的临床特征以及其危险因素。方法 收集南京鼓楼医院2014年1月至2016年12月住院的帕金森病患者资料111例,根据患者活动平衡信心量表（ABC量表）评分分为跌倒恐惧组(43例,38.7%)和不伴跌倒恐惧组(68例,61.3%)。收集所有患者的性别、年龄、病程、受教育年限、药物治疗等基本情况信息。采用Hoehn-Yahr分级、统一帕金森病评分量表运动部分（UPDRS-Ⅲ）评分、冻结步态问卷（FOGQ）、Berg平衡量表（BBS）评估受试者运动症状以及运动相关的情况。应用简易精神状态量表（MMSE）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、快动眼睡眠障碍筛查问卷（RBDSQ）、埃普沃思嗜睡量表（ESS）、疲劳严重度量表（FSS）等评估受试者的非运动症状。 分析帕金森病跌倒恐惧的危险因素。结果 跌倒恐惧组病程明显长于非跌倒恐惧组[(5.51±2.12)年 vs （3.24±1.56）年，P =0.042］。跌倒恐惧组UPDRS-Ⅲ、FOGQ评分、跌倒史例数、BBS、HAMA评分、左旋多巴等效剂量等相关因素均明显高于不伴跌倒恐惧组(P均<0.05)。Logistic多元回归结果显示,UPDRS-Ⅲ评分(B=-0.503,Or =0.529,P =0.007)、BBS分值(B=-0.005,Or =0.995,P =0.030)、FOGQ分值(B=-0.468,Or =0.627,P <0.01)均为帕金森病伴有跌倒恐惧的独立危险因素。结论 跌倒恐惧是帕金森病常见的症状,其发生与症状严重程度、平衡功能及冻结步态等因素相关。
Abstract:Objective To investigate the clinical features and risk factors of fear of falling (FOF) in patients with Parkinson′s disease (PD). Methods A total of 111 PD patients hospitalized in Nanjing Drum Tower Hospital between January 2014 and December 2016 were recruited and were divided into PD with FOF group (FOF group, n=43, 38. 7%) and PD without FOF group (non-FOF group, n=68, 61.3%) according to activities-specific balance confidence scale (ABC scale). The baseline information including gender, age, course of disease, years of education and drug treatment were collected. Hoehn-Yahr(H-Y) stage, unified Parkinson disease rating scale (UPDRS)-Ⅲ, freezing of gait questionnaire (FOGQ), Berg balance scale (BBS) were used to assess the motor symptoms and exercise-related symptoms of the objects. Mini mental state examination (MMSE), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), REM sleep behavior disorder screening questionnaire (RBDSQ), Epworth sleepiness scale (ESS), fatigue severity scale (FSS) were used to evaluate the non-motor symptoms of objects. The risk factors of FOF for Parkinson′s disease were analyzed. Results The duration of disease in FOF group was statistically longer than that in non-FOF group [(5.51±2.12)years vs (3.24±1.56) years, P=0.042]. The scales of UPDRS-Ⅲ, FOGQ, BBS, HAMA, levodopa equivalent dose (LED) and cases of falling history in PD with FOF group were significantly higher than those in non-FOF group (all P<0.05) . Logistic regression analysis showed that UPDRS-Ⅲ (B=-0. 503, OR=0. 529, P=0.007), BBS (B=-0.005, OR=0. 995,P=0.030) and FOGQ (B=-0. 468, OR=0. 627,P<0.001) were the independent risk factors of PD with FOF. Conclusion FOF is a common symptom of Parkinson′s disease, and its occurrence is related to the factors of symptom severity, balance function and frozen gait, etc.
keywords: Parkinson′s disease Fear of falling Freezing of gait Balance function Activities-specific balance confidence scale Unified Parkinson disease rating scale
文章编号： 中图分类号：R742.5 文献标志码：A
基金项目:国家自然科学基金(81571134)
| 作者 | 单位 |
| 张扬1 | 1.南京大学医学院附属鼓楼医院神经内科,江苏 南京 210008 |
| 冒萧萧2 | 2.南京医科大学鼓楼临床医学院神经内科,江苏 南京 210008 |
| 管得宁1 | 1.南京大学医学院附属鼓楼医院神经内科,江苏 南京 210008 |
| 徐运1 | 1.南京大学医学院附属鼓楼医院神经内科,江苏 南京 210008 |
引用文本：
张扬,冒萧萧,管得宁,等.探讨帕金森病患者跌倒恐惧的临床特征以及其危险因素[J].中国临床研究,2017,30(12):1608-1611.
张扬,冒萧萧,管得宁,等.探讨帕金森病患者跌倒恐惧的临床特征以及其危险因素[J].中国临床研究,2017,30(12):1608-1611.