帕金森病中主观症状与仪器化吞咽困难测量之间的关联
Associations between Subjective Symptoms and Instrumental Dysphagia Measures in Parkinson's Disease.
文献信息
| PMID | 42952272 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Urey Lee |
| 作者单位 | Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. |
| 期刊 | Movement disorders clinical practice |
| SCI 分区 | Q2 |
| IF | 3.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 吞咽困难是帕金森病（PD）的重要表现，可导致发病和死亡。尽管患者报告测量广泛用于筛查，但其与客观损害的一致性，尤其是随时间变化的一致性，仍不确定。
目的： 旨在探讨PD中患者报告的吞咽症状与客观发现之间的横断面和纵向关联。
方法： 我们回顾性分析了103例接受吞咽障碍问卷（SDQ）和视频透视吞咽研究的PD患者。视频透视吞咽困难量表（VDS）量化客观损害。在24例患者（39对配对观察）中检查纵向关联，中位随访时间为1.2年。使用多变量和线性混合效应模型调整年龄、性别、病程和Hoehn and Yahr量表。
结果： 横断面分析显示SDQ总分与VDS评分之间存在显著关联（β = 1.18，P < 0.001），咽部领域（β = 1.32）的关系强于口腔领域（β = 0.71）。较高的SDQ评分与较低的美国言语-语言-听力协会国家结局测量系统（ASHA NOMS）水平相关[比值比（OR）= 0.95，P = 0.010]。在纵向分析中，SDQ评分的变化与VDS评分的变化显著相关（总分：β = 0.78；口腔：β = 0.67；咽部：β = 0.75）。
结论： 在临床转诊的PD患者队列中，SDQ评分与客观吞咽损害的严重程度及个体内变化相关。尽管不能替代仪器评估，SDQ可能有助于追踪进展并识别进一步评估的需求。需要更大规模的前瞻性研究来阐明患者报告测量在PD长期吞咽困难监测中的作用。
英文摘要
BACKGROUND: Dysphagia is a critical manifestation of Parkinson's disease (PD) contributing to morbidity and mortality. Although patient-reported measures are widely used for screening, concordance with objective impairment, particularly over time, remains uncertain.
OBJECTIVES: The aim is to investigate cross-sectional and longitudinal associations between patient-reported swallowing symptoms and objective findings in PD.
METHODS: We retrospectively analyzed 103 PD patients who underwent the Swallowing Disturbance Questionnaire (SDQ) and videofluoroscopic swallowing study. The Videofluoroscopic Dysphagia Scale (VDS) quantified objective impairment. Longitudinal associations were examined in 24 patients (39 paired observations) over a median follow-up of 1.2 years. Multivariable and linear mixed-effects models were used for adjusting age, sex, disease duration, and Hoehn and Yahr scale.
RESULTS: Cross-sectional analysis demonstrated a significant association between total SDQ and VDS scores (β = 1.18, P < 0.001), with a stronger relationship in pharyngeal (β = 1.32) than oral domain (β = 0.71). Higher SDQ scores correlated with lower American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA NOMS) levels [odds ratio (OR) = 0.95, P = 0.010]. Changes in SDQ scores were significantly associated with changes in VDS scores in longitudinal analysis (total: β = 0.78; oral: β = 0.67; pharyngeal: β = 0.75).
CONCLUSIONS: In the clinically referred cohort of PD patients, SDQ scores were associated with the severity and within-person changes of objective swallowing impairment. Although not replacing instrumental assessments, SDQ may help track progression and identify the need for further evaluation. Larger prospective studies are needed to clarify the role of patient-reported measures in long-term dysphagia monitoring in PD.