塞哥维亚省帕金森病的自然史：一项长达20年的纵向研究中的残疾情况

Natural History of Parkinson's Disease in the Province of Segovia: Disability in a 20 Years Longitudinal Study.

作者信息

Duarte Jacinto, García Olmos Luis Miguel, Mendoza Amelia, Martínez Pueyo Ángel, Clavería Luis Erik

机构信息

Division of Neurology, General Hospital of Segovia, Segovia, Spain.

出版信息

Neurodegener Dis. 2015;15(2):87-92. doi: 10.1159/000369531. Epub 2015 Jan 22.

DOI:10.1159/000369531

PMID:25613012

Abstract

BACKGROUND

Parkinson's disease mainly affects the elderly population causing a progressive functional disability with motor, psychic, and cognitive deterioration.

OBJECTIVE

This study was carried out to evaluate disability caused by Parkinson's disease by analyzing the median time to reach Hoehn and Yahr stage III and to investigate predictor variables based on a 20-year longitudinal follow-up study.

METHODS

We examined 273 patients with Parkinson's disease recruited between 1978 and 1998. We performed a survival analysis using the Kaplan-Meier method to determine the time to disability and we used a Cox regression model to adjust prognosis factors.

RESULTS

The median time to reach Hoehn and Yahr stage III was 7.73 years (95% CI: 5.95-8.05). Independent predictors of disability were: age at onset, the hazard ratio (HR) = 1.10, 95% CI: 1.08-1.12; UPDRS II (activities of daily living) HR = 1.08, 95% CI: 1.03-1.14; and akinesia and rigidity at onset HR = 1.55, 95% CI: 1.07-2.24.

CONCLUSIONS

Patients with Parkinson's disease evolve gradually toward disability, and prognostic factors of this evolution were identified.

摘要

背景

帕金森病主要影响老年人群，导致运动、精神和认知功能逐渐衰退，造成进行性功能残疾。

目的

本研究旨在通过分析达到Hoehn和Yahr III期的中位时间来评估帕金森病所致残疾，并基于一项20年的纵向随访研究调查预测变量。

方法

我们检查了1978年至1998年间招募的273例帕金森病患者。我们使用Kaplan-Meier方法进行生存分析以确定残疾时间，并使用Cox回归模型调整预后因素。

结果

达到Hoehn和Yahr III期的中位时间为7.73年（95%可信区间：5.95 - 8.05）。残疾的独立预测因素为：发病年龄，风险比（HR）= 1.10，95%可信区间：1.08 - 1.12；统一帕金森病评定量表II（日常生活活动）HR = 1.08，95%可信区间：1.03 - 1.14；以及发病时的运动不能和强直HR = 1.55，95%可信区间：1.07 - 2.24。