接受丘脑底核刺激治疗的帕金森病患者的死亡率

Mortality in patients with Parkinson's disease treated by stimulation of the subthalamic nucleus.

作者信息

Schüpbach Michael W M, Welter Marie Laure, Bonnet Anne Marie, Elbaz Alexis, Grossardt Brandon R, Mesnage Valerie, Houeto Jean Luc, Maltête David, Mallet Luc, Rocca Walter A, Mallet Alain, Agid Yves

机构信息

Centre d'Investigation Clinique, Fédération de Neurologie and National Institute of Health and Medical Research (INSERM) Unit 679 (former Unit 289), Hôpital de la Salpêtrière, Paris, France.

出版信息

Mov Disord. 2007 Jan 15;22(2):257-61. doi: 10.1002/mds.21264.

DOI:10.1002/mds.21264

PMID:17149702

Abstract

Subthalamic nucleus (STN) stimulation improves motor disability and quality of life in patients with advanced Parkinson's disease (PD). Short-term mortality is low, but little is known about long-term mortality. We assessed mortality and causes of death in 171 consecutive PD patients treated by STN stimulation. Surgery was performed after a median lagtime of 13 years from PD onset at a median age of 57 years. The median follow-up after surgery was 41 months. Sixteen patients died 8 to 83 months after neurosurgery. Poorer cognitive function was the only predictive factor for mortality (standardized mortality ratio = 2.9; 95% confidence interval [CI], 1.6-4.7; P < 0.0001). Based on a historical comparison of 118 operated patients with 39 nonoperated patients from a different population, survival among operated patients was not better (hazard ratio = 1.2; 95% CI, 0.7-2.1).

摘要

丘脑底核（STN）刺激可改善晚期帕金森病（PD）患者的运动功能障碍和生活质量。短期死亡率较低，但关于长期死亡率的情况却知之甚少。我们评估了171例接受STN刺激治疗的连续性PD患者的死亡率及死亡原因。手术在PD发病后中位延迟13年、中位年龄57岁时进行。术后中位随访时间为41个月。16例患者在神经外科手术后8至83个月死亡。较差的认知功能是唯一的死亡预测因素（标准化死亡率比=2.9；95%置信区间[CI]，1.6 - 4.7；P<0.0001）。基于对118例手术患者与来自不同人群的39例未手术患者的历史对照，手术患者的生存率并无改善（风险比=1.2；95%CI，0.7 - 2.1）。