Lee Jong Hwa, Lee Kyeong Woo, Kim Sang Beom, Lee Sook Joung, Chun Sang Myung, Jung Sung Moon
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.
Department of Neurology, Dong-A University College of Medicine, Busan, Korea.
Ann Rehabil Med. 2016 Jun;40(3):440-6. doi: 10.5535/arm.2016.40.3.440. Epub 2016 Jun 29.
To describe the correlation between the functional dysphagia scale and aspiration pneumonia and which characteristics influence the occurrence of aspiration pneumonia in patients with idiopathic Parkinson disease.
Fifty-three patients with idiopathic Parkinson disease were prospectively evaluated in this study. Disease severity and functional status were measured by modified Hoehn and Yahr (H&Y) staging, Schwab and England activities of daily living (S-E ADL) scale and Korean version of Mini-Mental State Examination (K-MMSE). Swallowing function was evaluated by the functional dysphagia scale (FDS) and the penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study. The patients were followed up for 3 months and divided into two groups according to the occurrence of aspiration pneumonia. The correlation between the variables and aspiration pneumonia was analyzed.
Eight patients of the 53 patients were allocated to the aspiration pneumonia group and 45 patients to the non-aspiration pneumonia group. The patients in the aspiration pneumonia group had significantly higher H&Y staging, and scored lower on S-E ADL scale and K-MMSE. The patients in the aspiration pneumonia group had significantly higher scores on FDS and PAS. A multiple logistic regression analysis showed that the S-E ADL scale and the FDS were associated with the occurrence of aspiration pneumonia in the patients with Parkinson disease.
Given that the FDS can quantitatively assess the functional problems associated with dysphagia, it can be clinically effective in predicting the occurrence of aspiration pneumonia, and the FDS and the S-E ADL scale could be predictive variables for aspiration pneumonia in patients with Parkinson disease.
描述功能性吞咽困难量表与吸入性肺炎之间的相关性，以及哪些特征会影响特发性帕金森病患者发生吸入性肺炎。
本研究对53例特发性帕金森病患者进行了前瞻性评估。采用改良Hoehn和Yahr（H&Y）分期、Schwab和England日常生活活动（S-E ADL）量表以及韩国版简易精神状态检查表（K-MMSE）来测量疾病严重程度和功能状态。基于视频荧光吞咽造影检查，采用功能性吞咽困难量表（FDS）和渗透-误吸量表（PAS）评估吞咽功能。对患者进行3个月的随访，并根据是否发生吸入性肺炎分为两组。分析各变量与吸入性肺炎之间的相关性。
53例患者中，8例被分配到吸入性肺炎组，45例被分配到非吸入性肺炎组。吸入性肺炎组患者的H&Y分期显著更高，S-E ADL量表得分和K-MMSE得分更低。吸入性肺炎组患者的FDS和PAS得分显著更高。多因素logistic回归分析显示，S-E ADL量表和FDS与帕金森病患者发生吸入性肺炎有关。
鉴于FDS能够定量评估与吞咽困难相关的功能问题，它在预测吸入性肺炎的发生方面可能具有临床有效性，并且FDS和S-E ADL量表可能是帕金森病患者吸入性肺炎的预测变量。
