Schrag A, Jahanshahi M, Quinn N
Department of Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
J Neurol Neurosurg Psychiatry. 2000 Sep;69(3):308-12. doi: 10.1136/jnnp.69.3.308.
To identify the factors that determine quality of life (QoL) in patients with idiopathic Parkinson's disease in a population based sample. Quality of life (QoL) is increasingly recognised as a critical measure in health care as it incorporates the patients' own perspective of their health.
All patients with Parkinson's disease seen in a population based study on the prevalence of parkinsonism were asked to complete a disease-specific QoL questionnaire (PDQ-39) and the Beck depression inventory. A structured questionnaire interview and a complete neurological examination, including the Hoehn and Yahr scale, the Schwab and England disability scale, the motor part of the unified Parkinson's disease rating scale (UPDRS part III), and the mini mental state examination were performed by a neurologist on the same day.
The response rate was 78%. The factor most closely associated with QoL was the presence of depression, but disability, as measured by the Schwab and England scale, postural instability, and cognitive impairment additionally contributed to poor QoL. Although the UPDRS part III correlated significantly with QoL scores, it did not contribute substantially to predicting their variance once depression, disability, and postural instability had been taken into account. In addition, patients with akinetic rigid Parkinson's disease had worse QoL scores than those with tremor dominant disease, mainly due to impairment of axial features.
Depression, disability, postural instability, and cognitive impairment have the greatest influence on QoL in Parkinson's disease. The improvement of these features should therefore become an important target in the treatment of the disease.
在基于人群的样本中，确定影响特发性帕金森病患者生活质量（QoL）的因素。生活质量（QoL）日益被视为医疗保健中的一项关键指标，因为它纳入了患者对自身健康的看法。
在一项关于帕金森病患病率的基于人群的研究中，所有帕金森病患者均被要求完成一份特定疾病的生活质量问卷（PDQ - 39）和贝克抑郁量表。同一天，由一名神经科医生进行结构化问卷调查和全面的神经学检查，包括霍恩和雅尔分级量表、施瓦布和英格兰残疾量表、统一帕金森病评定量表运动部分（UPDRS第三部分）以及简易精神状态检查。
应答率为78%。与生活质量最密切相关的因素是抑郁的存在，但施瓦布和英格兰量表所衡量的残疾、姿势不稳以及认知障碍也会导致生活质量不佳。尽管UPDRS第三部分与生活质量得分显著相关，但在考虑抑郁、残疾和姿势不稳因素后，它对预测得分方差的贡献不大。此外，运动不能 - 强直型帕金森病患者的生活质量得分比震颤为主型患者更差，主要是由于轴性特征受损。
抑郁、残疾、姿势不稳和认知障碍对帕金森病患者的生活质量影响最大。因此，改善这些特征应成为该病治疗的一个重要目标。
