目的 分析帕金森病冻结步态患者跌倒风险的影响因素.方法 选取2022年1月至2023年6月就诊的帕金森病冻结步态患者为研究对象,将临床调查前3个月出现跌倒史的72例患者纳入跌倒组,同期选择未出现跌倒史的144例患者纳入未跌倒组.收集216例患者临床资料,以统一帕金森病评价量表第三部分(UPDRS-Ⅲ)评估患者运动障碍,以匹兹堡睡眠质量量表(PSQI)评估睡眠障碍,以Epworth嗜睡量表(ESS)评估日间嗜睡情况,以简明智力状态量表(MMSE)评估认知功能,以日常生活能力评分表(ADL)评估日常生活能力,以综合医院抑郁焦虑量表(HADS)评估情绪状态,以冻结步态问卷(FOG-Q)评估冻结步态严重程度.采用单因素、logistic多因素回归分析帕金森病冻结步态患者跌倒的影响因素.结果 72例帕金森病冻结步态跌倒患者中,15例出现骨折,有58.33%患者跌倒发生在居家护理中,41.67%患者跌倒发生在住院期间.logistic回归分析显示,主要照顾者、UPDRS-Ⅲ评分、FOG-Q评分、MMSE评分、规律步态训练是帕金森病冻结步态患者跌倒的影响因素.结论 帕金森病冻结步态患者跌倒受主要照顾者、规律步态训练等因素影响.
Objective To analyze the influencing factors of falls in patients with Parkinson's disease freezing gait.Methods A total of 216 patients with Parkinson's disease freezing gait who were admitted to our hospital from January 2022 to June 2023 were selected as the research subjects.Among them,72 patients with a history of falls in the previous 3 months were included in the fall group,and 144 patients without a history of falls were selected in the non-fall group.Clinical data were collected from all 216 patients,and the unified Parkinson's disease rating scale-Ⅲ(UPDRS-Ⅲ)was used to assess motor dysfunction,the Pittsburgh sleep quality index(PSQI)was used to assess sleep disturbance,the Epworth sleepiness scale(ESS)was used to assess daytime sleepiness,the mini-mental state examination(MMSE)was used to assess cognitive function,the activities of daily living scale(ADL)was used to assess daily living ability,and the hospital anxiety and depression scale(HADS)was used to assess emotional state.The freezing gait questionnaire was used to assess the state of freezing gait.The factors influencing falls in patients with Parkinson's disease freezing gait were analyzed using univariate and logistic multivariate regression analysis.Results Among the 72 patients with Parkinson's disease freezing gait who fell,15 suffered from fractures,and 58.33%of them fell at home care,while 41.67%fell during hospitalization.Logistic regression analysis showed that the main caregiver,UPDRS-Ⅲ score,FOG-Q score,MMSE score,regular gait training were the influencing factors of falls in patients with Parkinson's disease freezing gait.Conclusion Falls in patients with Parkinson's disease freezing gait are mainly affected by factors such as primary caregivers and regular gait training.