帕金森病患者日常生活活动能力的主要影响因素

关键词：帕金森病  日常生活活动  认知  焦虑

Keywords:Parkinson′s disease  activities of daily living  cognition  anxiety

摘要：

      目的：探讨影响帕金森病（PD）患者日常生活活动能力的主要因素。方法：采用PD统一评分量表第2部分(UPDRSⅡ)对107例PD患者的ADL能力进行评估，并选用Hoehn-Yahr分级帕金森病统一评分量表-Ⅲ（UPDRS-Ⅲ）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、简易精神状态量表（MMSE）、蒙特利尔认知评估（MOCA）、睡眠量表及Epworth嗜睡评分量表(ESS)等量表作为评估患者运动功能、焦虑、抑郁、认知、记忆、睡眠状况等的指标。同时结合年龄、性别、发病时间、目前左旋多巴用量等可能影响患者ADL能力的因素评估上述指标对PD患者ADL影响的程度。结果：逐步法多元线性回归分析提示：影响PD患者ADL能力的主要因素是UPDRS-Ⅲ、ESS、病程及受教育程度。结论：运动功能及心理因素是影响PD患者ADL能力的主要因素。因此，在治疗过程应联合药物治疗和康复治疗，以提高PD患者的ADL能力。

Abstract:

      Objective: To identify the essential factors which may influence activities of daily living(ADL) in patiens with Parkinson′s disease(PD). Method: The ADL in 107 patients with PD were assessed by UPDRSⅡ. Meanwhile, motor function, anxiety,depression, cognition, memory and sleep state were measured by Hoehn-Yahr stage, unified Parkinson's disease rating score Ⅲ(UPDRS-Ⅲ), Hamilton anxiety scale(HAMA), Hamilton depression scale(HAMD), mini-mental state examination(MMSE), Montreal cognition assess(MOCA). The factors which may affect ADL in patients,such as age,gender,onset and drugs were also investigated. Result: Multiple stepwise regression analysis showed that the main factors involved in ADL in patients with PD were UPDRS-Ⅲ，ESS, onset and level of education. Conclusion: The main factors influencing ADL in PD patiens were motor function and mental factors. So drug treatment and rehabilitation treatment should be combined to improve ADL in patiens with PD.