Section of Neurology, Hospital A. Marcide, Ferrol, Spain.
Eur J Neurol. 2012 Sep;19(9):1261-5. doi: 10.1111/j.1468-1331.2011.03630.x. Epub 2012 Jan 17.
Continuous duodenal levodopa infusion (DLI) is an effective therapy that improves quality of life (QoL) in advanced Parkinson's disease (PD). However, the impact of DLI on caregivers' stress and burden has not been reported.
We evaluated prospectively open-label seven advanced PD patients (65.7 ± 9.6 years, 71.4% men) treated with DLI. Schwab & England Activities of Daily Living Scale (ADLS), 39-item Parkinson's disease QoL Questionnaire Summary Index score (PDQ-39SI), Zarit Caregiver Burden Interview (ZCBI), and Caregiver Strain Index (CSI) were used. Comparisons were made between scores obtained at baseline and those at a mean follow-up of 31.4 ± 7.9 months (range, 23-42).
In patients, mean ± SD ADLS was increased from 50 ± 8.2 to 80 ± 11.6 (P = 0.014), and mean ± SD PDQ-39SI was decreased from 53.7 ± 11.9 to 33.6 ± 12.8 (P = 0.018). In caregivers, ZCBI decreased from 43 ± 13.3 to 20.7 ± 12.1 (P = 0.018) and CSI from 6.3 ± 2.5 to 1.6 ± 0.9 (P = 0.018). At baseline, 57.1% of caregivers reported moderate to severe burden (ZCBI 41-88) compared to 28.6% at the end of the follow-up (P = 0.015); at that time, no caregiver reported high level of stress (CSI ≥ 7) compared to 57.1% at baseline (P = 0.046). There were significant correlations between ZCBI and CSI improvement (r = 0.813, P = 0.026), ZCBI and PDQ-39SI (r = 0.875, P = 0.01), and ZCBI and ADLS (r = 0.813, P = 0.026).
Duodenal levodopa infusion-related clinical improvement in patients with advanced PD leads to substantial reductions in caregivers' stress and burden.
连续十二指肠左旋多巴输注（DLI）是一种有效的治疗方法，可改善晚期帕金森病（PD）患者的生活质量（QoL）。然而，DLI 对照顾者的压力和负担的影响尚未报道。
我们前瞻性地评估了 7 名接受 DLI 治疗的晚期 PD 患者（65.7 ± 9.6 岁，71.4%为男性）。使用 Schwab & England 日常生活活动量表（ADLS）、39 项帕金森病生活质量问卷综合指数评分（PDQ-39SI）、Zarit 照顾者负担量表（ZCBI）和照顾者压力指数（CSI）进行评估。比较了基线时和平均随访 31.4 ± 7.9 个月（范围 23-42 个月）时的评分。
患者的平均 ± SD ADLS 从 50 ± 8.2 增加到 80 ± 11.6（P = 0.014），平均 ± SD PDQ-39SI 从 53.7 ± 11.9 降低至 33.6 ± 12.8（P = 0.018）。在照顾者中，ZCBI 从 43 ± 13.3 降至 20.7 ± 12.1（P = 0.018），CSI 从 6.3 ± 2.5 降至 1.6 ± 0.9（P = 0.018）。基线时，57.1%的照顾者报告有中度至重度负担（ZCBI 41-88），而随访结束时这一比例为 28.6%（P = 0.015）；此时，没有照顾者报告有高度压力（CSI ≥ 7），而基线时这一比例为 57.1%（P = 0.046）。ZCBI 和 CSI 改善之间存在显著相关性（r = 0.813，P = 0.026），ZCBI 和 PDQ-39SI 之间存在显著相关性（r = 0.875，P = 0.01），ZCBI 和 ADLS 之间存在显著相关性（r = 0.813，P = 0.026）。
晚期 PD 患者接受 DLI 治疗后临床状况改善，可显著降低照顾者的压力和负担。
