Abstract: Objective To explore the effect of deep brain stimulation on quality of life in patients with medium-late stage Parkinson's disease.Methods There were 82 males and 85 females in this group.Their ages ranged from 41 to 77 years(mean 62.55 years).Their illness duration ranged from 3 to 22 years(mean 5.52 years).The clinical classification showed tremor-type in 35 cases,rigidity-type in 59 cases and tremor-rigidity-mixed-type in 73 cases.All the 167 cases were divided into three different groups according to different treatment methods:DBS group,lesioning group and medical treatment alone group.Activity of Daily Living(ADL) Scale and Parkinson's Disease Questionnaire (PDQ-39) were used to evaluate the patient's quality of life(QOL) before the therapy and 12 months after the therapy respectively.Results Bilateral STN-DBS was performed in 22 cases,deep nuclus lesioning was performed in 74 cases(including Gpi in 8 cases and Vim in 66 cases),and 71 cases received medical treatment alone.There was significant difference(P<0.05)in UPDRS of both surgical groups between 1 week before-operation and 1 year after-operation.12 months after the operation the ADL scores of both surgical groups were significantly higher than those before treatment(P＜0.05),and PDQ-39 scores were significantly lower than those before treatment(P＜0.05).Meanwhile the ADL scores of both surgical groups were significantly higher than those of medical treatment alone group(P＜0.05),and PDQ-39 scores were significantly lower than those of medical treatment alone group(P＜0.05).The ADL scores of DBS group were significantly higher than those of lesioning group(P＜0.05),and PDQ-39 scores of DBS were significantly lower than those of lesioning group(P＜0.05).Conclusion DBS not only can improve the motor symptoms of PD significantly,but also can ameliorate the non-motor symptoms (NMS),which can greatly improve the quality of life in patients with medium-late stage Parkinson's disease.

Key words: Deep brain stimulation, Medium-late stage PD, Quality of life

摘要： 目的 探讨脑深部电刺激手术对中晚期帕金森病患者生活质量的影响。方法 本组男82例,女85例,年龄41~77岁,平均62.55岁。病程3~22年,平均5.52年。临床分型:震颤型35例,僵直型59例,混合型73例。将这167例患者分为三个不同的治疗组:DBS组、毁损组和单纯药物治疗组。分别于治疗前和治疗后12个月采用日常生活能力评定量表(ADL)和39项帕金森病生存质量调查问卷(PDQ-39)评估患者的生活质量。结果 22例患者行了双侧STN-DBS手术,74例患者行了脑深部核团毁损术(其中8例患者行Gpi毁损术,66例行Vim毁损术),71例患者行单纯药物治疗。两组手术患者术后1 年的UPDRS 运动功能与术前1周进行比较,均明显好于术前(P<0.05)。两组手术患者治疗后12个月ADL量表评分均显著高于本组术前(P＜0.05),且PDQ-39评分均显著低于本组治疗前(P＜0.05)。两组手术组患者治疗后12个月ADL量表评分均显著高于单纯药物治疗组(P＜0.05),且PDQ-39评分均显著低于单纯药物治疗组(P＜0.05)。DBS手术组术后ADL量表评分显著高于毁损手术组(P＜0.05),且PDQ-39评分也显著低于毁损手术组(P＜0.05)。结论 脑深部电刺激术不仅能显著改善帕金森病的运动症状,还能改善患者的非运动症状,从而大大提高其生活质量。

关键词: 脑深部电刺激术, 中晚期帕金森病, 生活质量