Martínez-Martín P, Valldeoriola F, Molinuevo J L, Nobbe F A, Rumià J, Tolosa E
Neurology Unit, Hospital Universitario de Getafe, Madrid, Spain.
Mov Disord. 2000 Jan;15(1):65-70. doi: 10.1002/1531-8257(200001)15:1<65::aid-mds1011>3.0.co;2-y.
The purpose of this study was to analyze the effect of stereotactic neurophysiologically guided pallidotomy on health-related quality of life (QoL) of patients with Parkinson's disease (PD). Eleven patients with PD (seven men, four women; mean age, 57.2 years; mean duration of disease, 14 years) with motor complications refractory to medical therapy underwent unilateral pallidotomy. Clinical assessment was carried out a week before surgery and 4 months after the surgical procedure and was based on the Core Assessment Program for Intracerebral Transplantations protocol. QoL was measured by means of the PDQ-39. A set of rating scales (Hoehn & Yahr, Unified Parkinson's Disease Rating Scale, Schwab and England, Northwestern University Disability Scale of Walking, Abnormal Involuntary Movement Scale), timed tests, and self-evaluations of motor function and mood were applied. Improvement was found in dyskinesias (74%) and off-period disability (42%). Cardinal motor signs improved significantly (30%-59%). Four dimensions of the PDQ-39 (Mobility, ADL, Emotions, Bodily Pain) showed a significant improvement (p <0.01-0.001). The global effect on QoL, measured through the PDQ-39 Summary Index (35.3%; 95% confidence interval: 15.60-54.97), was also significant (p<0.01) but unrelated to major clinical changes. Pallidotomy significantly improves QoL in patients with advanced PD. QoL measurement provides relevant information that is probably not attainable by clinical assessment.
本研究旨在分析立体定向神经生理学引导下的苍白球切开术对帕金森病（PD）患者健康相关生活质量（QoL）的影响。11例药物治疗难治性运动并发症的PD患者（7例男性，4例女性；平均年龄57.2岁；平均病程14年）接受了单侧苍白球切开术。术前一周和术后4个月进行了临床评估，评估基于脑内移植核心评估程序方案。通过PDQ-39测量生活质量。应用了一组评定量表（Hoehn&Yahr量表、统一帕金森病评定量表、施瓦布和英格兰量表、西北大学步行残疾量表、异常不自主运动量表）、定时测试以及运动功能和情绪的自我评估。发现异动症（74%）和关期残疾（42%）有所改善。主要运动体征显著改善（30%-59%）。PDQ-39的四个维度（运动能力、日常生活活动、情绪、身体疼痛）显示出显著改善（p<0.01-0.001）。通过PDQ-39总结指数衡量的对生活质量的总体影响（35.3%；95%置信区间：15.60-54.97）也很显著（p<0.01），但与主要临床变化无关。苍白球切开术显著改善了晚期PD患者的生活质量。生活质量测量提供了临床评估可能无法获得的相关信息。
