CAJ | 학술논문

目的：研究早期帕金森病(PD)患者健康相关生活质量(health-related quality of life, HR-QOL)的特点；探讨运动症状和非运动症状对早期PD患者HR-QOL的影响。方法筛选出97例早期PD患者入组。采用统一帕金森病评分表(UPDRS)和Hoehn-Yahr评价运动症状，采用流行病学研究中心编制的抑郁量表(CES-D)、匹兹堡睡眠质量指数(PSQI)、疲劳量表（FSS）分别对抑郁、睡眠障碍、疲劳等非运动症状进行评价；采用36条目简化医疗结局调查问卷(SF-36)评价HR-QOL。采用逐步多元线性回归分析深入探讨各种运动和非运动症状变量对HR-QOL的影响。结果 UPDRS第3部分分值(22.7±8.9)、Hoehn-Yahr分期(2.1±0.6)和强直分值(4.3±2.7)仅能解释SF-36总分变化的19.1％（R2=0.191)。CES-D、FSS和PSQI分值等非运动症状变量引入回归方程后，SF-36总分可被解释的部分由19.1％增加至61.9％(R2=0.619)。引入CES-D分值后，SF-36总分可被解释的部分增加了43.9％(R2=0.439)。结论 PD症状严重影响早期患者的HR-QOL。运动症状对HR-QOL存在影响，但影响的作用有限。抑郁、疲劳和睡眠障碍这3个非运动症状是导致早期PD患者HR-QOL恶化的主要原因。其中，抑郁症状是HR-QOL恶化强预测因素。
목적：연구조기파금삼병(PD)환자건강상관생활질량(health-related quality of life, HR-QOL)적특점；탐토운동증상화비운동증상대조기PD환자HR-QOL적영향。방법사선출97례조기PD환자입조。채용통일파금삼병평분표(UPDRS)화Hoehn-Yahr평개운동증상，채용류행병학연구중심편제적억욱량표(CES-D)、필자보수면질량지수(PSQI)、피로량표（FSS）분별대억욱、수면장애、피로등비운동증상진행평개；채용36조목간화의료결국조사문권(SF-36)평개HR-QOL。채용축보다원선성회귀분석심입탐토각충운동화비운동증상변량대HR-QOL적영향。결과 UPDRS제3부분분치(22.7±8.9)、Hoehn-Yahr분기(2.1±0.6)화강직분치(4.3±2.7)부능해석SF-36총분변화적19.1％（R2=0.191)。CES-D、FSS화PSQI분치등비운동증상변량인입회귀방정후，SF-36총분가피해석적부분유19.1％증가지61.9％(R2=0.619)。인입CES-D분치후，SF-36총분가피해석적부분증가료43.9％(R2=0.439)。결론 PD증상엄중영향조기환자적HR-QOL。운동증상대HR-QOL존재영향，단영향적작용유한。억욱、피로화수면장애저3개비운동증상시도치조기PD환자HR-QOL악화적주요원인。기중，억욱증상시HR-QOL악화강예측인소。
Objective To investigate the characteristics of health related quality of life(HR-QOL) in patients with early Parkinson’s disease(PD), to identify the motor and non-motor factors that are associated with a poorer quality of life in patients with early PD.Methods All 97 patients with early PD were identified in a clinical-based study.Motor functions were measured by Uniifed Parkinson’s Disease Rating Scale (UPDRS) and Hoehn-Yahr Scale. Non-motor variables were assessed by Center of Epidemiological Survey Depression Scale(CES-D) for depressive symptoms,Pittsburg Sleep Quality Index(PSQI)for sleep disturbance,Fatigue Severity scale (FSS) for fatigue,HR-QOL was measured by SF-36. Multiple regression analyses Were used to determine which variable were strongly associated with lower levels of quality of life.Results The motor score of the UPDRS (22.7±8.9).Hoehn-Yahr stage(2.1±0.6),together with the rigidity score(4.3±2.7),only accounted for 19.1%(R2=0.191)of the variance of SF-36 total score.The variables that most strongly predicted a low total SF-36 Score were non-motor factors,particularly depressive symptoms,sleep disorders and fatigue.When the CES-D,FSS,and PSQI score were included in the model, the R2 increased from 0.191 to 0.619, indicating that 61.9 % of the variance in HR-QOL could be explained if additional CES-D,FSS and PSQI scores were known.Depressive symptoms, as measured by CES-D, had an overwhelming impact on HR-QOL.When CES-D score was included, the R2 change was 0.439.which indicated that additional 43.9 % of the variability in HR-QOL could be explained by adding depressive symptoms .Conclusions PD has a substantial impact on HR-QOL,even if in its early stage.Depressive symptoms,sleep disorders and fatigue correlated strongly with lower quality of life.Depressive symptoms appeared to be the strongest determinant of HR-QOL in early PD patients.