Neurology:帕金森病患者中运动和非运动症状与健康相关生活质量的关系

2022-05-26 Naomi MedSci原创

近日,研究人员发现潜在的可治疗的运动和非运动症状,特别是神经精神症状,是PwPD患者HRQOL变化的主要原因。这一发现为临床医生的干预和未来的症状管理研究提供了目标,以优化帕金森病患者的HRQOL。

健康相关生活质量(HRQOL)作为对患者幸福感的综合评价、临床医生治疗的指导思想和帕金森病患者的治疗试验结果指标,受到越来越多的关注。在大量帕金森病患者(PwPD)中,HRQOL的关键决定因素尚未被研究。近日,有研究人员评估了PwPD在线大队列中健康相关生活质量(HRQOL)的相关性。

作为正在进行的在线队列研究的一部分,研究人员对23,058名PwPD患者进行了横断面分析。采用EQ-5D-5L工具对HRQOL进行单因素和逐步多元线性回归分析。此外还进行了交互分析,以评估运动症状对HRQOL影响的异质性,并进行Spearman相关分析,以评估非运动症状与HRQOL的相关性。

  • 在多元线性回归模型中,中度或重度抑郁、较严重的运动症状和较高的内科合并症负担的参与者的情商指数最显著地降低了高危生活质量(β分别为-0.11、-0.18、-0.02、0.01,P均<0.001)。
  • 交互作用分析显示,运动症状越严重,对女性、低教育水平、低收入、抑郁越严重、认知障碍越严重的个体的影响越大(交互作用项p≤0.01)。
  • 神经精神症状和跌倒与生活质量呈负相关(Rho=-0.31-0.37,p<0.0001)。

潜在的可治疗的运动和非运动症状,特别是神经精神症状,是PwPD患者HRQOL变化的主要原因。运动症状可能在不同的人口和临床亚群中对HRQOL有不同的影响,突出了未来健康差异研究的重要领域。这一发现为临床医生的干预和未来的症状管理研究提供了目标,以优化帕金森病患者的HRQOL。

这项研究提供了第二类证据,表明运动和神经精神症状与PwPD患者的HRQOL有关。

文献来源:Bock MA, Brown EG, Zhang L, Tanner C. Association of Motor and Nonmotor Symptoms With Health-Related Quality of Life in a Large Online Cohort of People With Parkinson Disease [published online ahead of print, 2022 Apr 13]. Neurology. 2022;10.1212/WNL.0000000000200113. doi:10.1212/WNL.0000000000200113

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    2022-09-12 yinhl1978
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