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丘脑底核刺激术后帕金森病患者的生活质量:一项用于结局预测的观察性队列研究。

Quality of life in patients with Parkinson's disease after subthalamic stimulation: An observational cohort study for outcome prediction.

作者信息

Jiang Jiin-Ling, Chen Shin-Yuan, Tsai Sheng-Tzung

机构信息

Department of Nursing, Tzu Chi University, Hualien, Taiwan.

Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.

出版信息

Tzu Chi Med J. 2019 Apr-Jun;31(2):107-112. doi: 10.4103/tcmj.tcmj_92_18.

Abstract

OBJECTIVE

The objective of this study was to investigate the changes in health-related quality of life (HRQoL) and motor and depressive symptoms in patients with Parkinson's disease (PD) from baseline to 12 months following subthalamic nucleus deep brain stimulation (STN-DBS).

MATERIALS AND METHODS

The study utilized a prospective observational cohort design. Thirty-three PD patients with a good levodopa response but drug-related morbidity were included. PD Questionnaire-39 (PDQ-39) scores, unified PD rating scale (UPDRS) scores, Hoehn and Yahr stages, Beck Depression Inventory-II scores, and levodopa equivalent daily doses (LEDD) were obtained at baseline and 1 year after surgery.

RESULTS

The enrolled patients showed a significant HRQoL improvement of 21.43% at 12 months after STN-DBS as assessed by the PDQ-39 total score. There was a 34.92% improvement in UPDRS scores after STN-DBS at 1 year follow-up. Subitem analysis revealed significant improvement in UPDRS part II, III, and IV scores. The LEDD was significantly reduced by up to 27.36% 12 months after surgery. The preoperative PDQ-39 total score and LEDD predicted postoperative HRQoL in PD following STN-DBS.

CONCLUSIONS

The current study demonstrated that STN-DBS surgery significantly improved HRQoL and motor outcomes of patients with PD. The preoperative PDQ-39 score and LEDD were predictors of the efficacy of postoperative HRQoL following surgery.

摘要

目的

本研究的目的是调查帕金森病(PD)患者从基线到丘脑底核深部脑刺激(STN-DBS)术后12个月期间与健康相关的生活质量(HRQoL)以及运动和抑郁症状的变化。

材料与方法

本研究采用前瞻性观察性队列设计。纳入33例对左旋多巴反应良好但有药物相关并发症的PD患者。在基线期和术后1年获取帕金森病问卷-39(PDQ-39)评分、统一帕金森病评定量表(UPDRS)评分、Hoehn和Yahr分期、贝克抑郁量表第二版(BDI-II)评分以及左旋多巴等效日剂量(LEDD)。

结果

根据PDQ-39总分评估,入组患者在STN-DBS术后12个月时HRQoL显著改善了21.43%。在1年随访时,STN-DBS术后UPDRS评分改善了34.92%。子项目分析显示UPDRS第二、三、四部分评分有显著改善。术后12个月LEDD显著降低了多达27.36%。术前PDQ-39总分和LEDD可预测STN-DBS术后PD患者的术后HRQoL。

结论

本研究表明,STN-DBS手术显著改善了PD患者的HRQoL和运动结局。术前PDQ-39评分和LEDD是术后HRQoL疗效的预测指标。

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