摘要
目的了解并发焦虑、抑郁和睡眠障碍的帕金森病(Parkinson's disease,PD)患者临床特征。方法对并发焦虑、抑郁和睡眠障碍PD 135例的临床资料进行回顾分析。结果 135例PD并发焦虑42例,以轻中度焦虑居多,男女比1∶1. 33;并发抑郁39例,中度抑郁居多,男女比1∶1. 29;并发睡眠障碍25例,中度睡眠障碍居多,男女比1∶1. 08;同时并发焦虑、抑郁和睡眠障碍29例,中度居多,男女比1∶1. 07。65～80岁PD患者并发焦虑、抑郁和睡眠障碍率最高,与其他年龄段(≥80岁、50～65岁、<50岁)比较差异有统计学意义(P <0. 05)。改良Hoehn-Yahr(H-Y)分级2. 5～4. 0级PD患者并发焦虑、抑郁和睡眠障碍率最高,明显高于改良H-Y分级1. 0～2. 5级和4. 0～5. 0级PD患者,差异有统计学意义(P <0. 05)。治疗6周后,分别并发焦虑、抑郁、睡眠障碍及同时并发焦虑、抑郁、睡眠障碍PD患者总有效率均高于80. 00%。治疗4和6周后,并发焦虑、抑郁和睡眠障碍的帕金森病135例PD评价量表Ⅲ、改良H-Y分级、汉密尔顿焦虑评价量表、汉密尔顿抑郁评价量表、匹兹堡睡眠指数量表及Epworth嗜睡量表评分均较治疗前明显降低,差异有统计学意义(P <0. 05)。结论女性较男性PD患者更易发生焦虑和抑郁,但在睡眠障碍方面差异不大; 65～80岁PD患者并发焦虑、抑郁和睡眠障碍率最高;改良H-Y分级2. 5～4. 0级PD患者并发焦虑、抑郁和睡眠障碍率最高。盐酸帕罗西汀和右佐匹克隆治疗并发焦虑、抑郁、睡眠障碍PD患者效果显著,还可一定程度缓解PD症状。
Objective To observe the clinical features of patients with Parkinson's disease(PD)combined with anxiety,depression and sleep disorders.Methods The clinical data of 135 patients with PD combined with anxiety,depression and sleep disorder were retrospectively analyzed.Results Of 135 PD patients,forty-two had concurrent anxiety,most of which were mild to moderate,with a ratio of 1∶1.33 for male and female.Thirty-nine cases had depression,predominantly with moderate depression,and the ratio of male to female was 1∶1.29.Twenty-five cases experienced sleep disorder,most of which were moderate,and the ratio of male to female was 1∶1.08.The number of PD patients with anxiety,depression and sleep disorder was 29,most of which were moderate,and the ratio of male to female was 1∶1.07.PD patients aged 65 to 80 years had the highest rate of anxiety,depression and sleep disorder,which was significantly different from other age groups(≥80 years of age,50 to 65 years of age,<50 years of age,P<0.05).The rate of anxiety,depression and sleep disorder in modified Hoehn-Yahr(H-Y)grade 2.5~4.0 PD patients was the highest,significantly higher than that in grade 1.0~2.5 PD patients and grade 4.0~5.0 PD patients,and the difference was statistically significant(P<0.05).After 6 weeks of treatment,the total effective rate of PD patients complicated with anxiety,depression and sleep disorder respectively,as well as with anxiety,depression and sleep disorder was higher than 80.00%.At 4 and 6 weeks after treatment,the Unified Parkinson's Disease Rating Scale-Ⅲ,modified H-Y,Hamilton Anxiety Scale and Hamilton Depression Scale,Pittsburgh Sleep Quality Index,and the Epworth Sleeping Scale score were significantly decreased,and the difference was statistically significant(P<0.05).Conclusion Female PD patients are more prone to anxiety and depression than male PD patients,but there is no significant difference in sleep disorders.In particular,PD patients aged 65 to 80 years have the highest rates of anxiety,depression and sleep disorder.The rate of anxiety,depression and sleep disorder was the highest in PD patients with modified H-Y grade 2.5~4.0 Paroxetine and Dexzopiclone have significant clinical effects on PD patients complicated with anxiety,depression and sleep disorder,and can relieve PD symptoms to some extent.
作者
吕冬芳
王雪笠
朱艳霞
赵莉
郭琦
LV Dong fang;WANG Xue-li;ZHU Yan-xia;ZHAO Li;GUO Qi(Department of Neurology,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Outpatient,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)
出处
《临床误诊误治》
2019年第2期83-88,共6页
Clinical Misdiagnosis & Mistherapy
