摘要
目的探讨帕金森病伴发抑郁的临床特征及其对患者生活质量的影响。方法收集2012年12月至2015年3月在北京医院帕金森病专病门诊就诊的帕金森病患者195例以及常规体检的正常对照63名。记录帕金森病患者的性别、学历、发病年龄、病程等一般病史资料,采用统一帕金森病评分量表及Hoehn-Yahr分期评价疾病的严重程度,采用汉密尔顿抑郁量表(Hamilton Depression Rating Scale-24,HAMD-24)、汉密尔顿焦虑量表、帕金森病生活质量问卷评价患者抑郁、焦虑的严重程度及患者的生活质量。采用SPSS 21.0统计学软件对帕金森病相关抑郁进行横断面资料分析。结果帕金森病患者抑郁的发生率(54.4%)显著高于正常对照组(10.9%)。195例帕金森病患者的HAMD平均得分为(8.74±5.51)分,其中不伴抑郁者89例(45.6%),伴随抑郁者106例(54.4%),且以轻度抑郁为主(95例)。伴抑郁与不伴抑郁的帕金森病患者在焦虑躯体症状[4(2,5)分与1(0,2)分,Z=-8.69,P=0.00]、认知因子[1(0,2)分与0(0,0)分,Z=-7.01,P=0.00]、阻滞因子[2(1,3)分与0(0,1)分,Z=-7.95,P=0.00]、睡眠因子[2(1,3)分与0(0,1)分,Z=-6.42,P=0.00]及绝望因子[2(1,3)分和1(0,1)分,Z=-7.16,P=0.00]方面均有明显差异,而在体重因子[0(0,0)分和0(0,0)分,Z=-1.28,P=0.20]、症状日夜变化[0(0,0)分和0(0,0)分,Z=-0.19,P=0.85]方面差异不明显。伴抑郁与不伴抑郁帕金森病患者的生活质量总分[30(22,44)分与14(5,24)分,Z=-7.03,P=0.00]、运动能力[6(2,13)分与1(0,5)分,Z=-3.67,P=0.00]、日常生活[4(1,8)分与1(0,4)分,Z=-2.81,P=0.01]、情感健康状态[5(2,11)分与0(0,2)分,Z=-5.82,P=0.00]、耻辱[2(0,5)分与0(0,1)分,Z=-3.10,P=0.00]、社会支持[0(0,1)分与0(0,0)分,Z=-2.86,P=0.00]、认知功能[4(2,6)分与2(0,4)分,Z=-2.87,P=0.00]、社交[1(0,3)分与0(0,1)分,Z=-3.25,P=0.00]及躯体不适[3(1,6)分与1(0,2)分,Z=-3.91,P=0.00]各个方面差异均有统计学意义。结论帕金森病患者抑郁症状发生率高,以轻度为主;抑郁症状可显著影响患者的生活质量。
ObjectiveTo investigate the prevalence of depression in Parkinson's disease (PD) patients, analyze the clinical features of depression in PD patients, and evaluate its impact on quality of life.MethodsOne hundred and ninety-five PD patients and 63 normol controls were recruited in this study. The detailed clinical information was documented. Unified Parkinson′s Disease Rating Scale and Hoehn-Yahr stage were used to evaluate the severity of motor function impairment in PD patients. Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale were employed to assess the severity of depression and anxiety in PD patients. The 39-item Parkinson′s Disease Questionnaire was applied to assess the quality of life. The cross-sectional data were calculated with SPSS 21.0 statistic software, and P〈0.05 was considered statistically significant.ResultsThe average score of HAMD was 8.74±5.51 in 195 PD patients. Depressive symptoms were found in 54.4%of the PD patients (mild depression 48.7% and moderate depression 5.6%). Depression significantly impaired the quality of life in PD. Compared with PD without depression, PD with depression earned more scores in anxiety factor (4 (2, 5) vs 1(0, 2), Z=-8.69, P=0.00), blocker factor (2 (1, 3) vs 0(0, 1), Z=-7.95, P=0.00), cognitive factor (1 (0, 2) vs 0(0, 0), Z=-7.01, P=0.00), sleep factor (2(1, 3) vs 0(0, 1), Z=-6.42, P=0.00) and despair factor (2(1, 3) vs 1(0, 1), Z=-7.16, P=0.00). There was no significant difference in day and night change (0(0, 0) vs 0(0, 0), Z=-0.19, P=0.85) and body weight (0(0, 0) vs 0(0, 0), Z=-1.28, P=0.20) between these two groups. The PD with depression obtained higher scores in total quality of life (30(22, 44) vs 14 (5, 24), Z=-7.03, P=0.00), motor function (6 (2, 13) vs 1 (0, 5), Z=-3.67, P=0.00), daily life ability (4 (1, 8) vs 1 (0, 4), Z=-2.81, P=0.01) , emotional health (5 (2, 11) vs 0 (0, 2), Z=-5.82, P=0.00), humiliation (2 (0, 5) vs 0 (0, 1), Z=-3.10, P=0.00), social support (0 (0, 1) vs 0 (0, 0), Z=-2.86, P=0.00), recognition function (4 (2, 6) vs 2 (0, 4), Z=-2.87, P=0.00), sociability(1(0, 3) vs 0(0, 1), Z=-3.25, P=0.00), and body pain (3 (1, 6) vs 1 (0, 2), Z=-3.91, P=0.00) than patients without depression.ConclusionsIncidence of depression (mainly mild) in PD patients is high. Depressive symptoms significantly affect the quality of life of PD patients.
作者
金丽莹
苏闻
金莹
李淑华
马欣昕
刘慧菁
杜危
蔡晓杰
陈海波
Jin Liying;Su Wen;Jin Ying;Li Shuhua;Ma Xinxin;Liu Huijing;Du Wei;Cai Xiaojie;Chen Haibo(Department of Neurology,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2018年第7期510-514,共5页
Chinese Journal of Neurology
基金
首都卫生发展科研专项项目(首发2011-4011-01)
关键词
帕金森病
抑郁
生活质量
Parkinson disease
Depression
Quality of life