摘要
目的:探讨情绪障碍是否首发对帕金森病(PD)的影响。方法:回顾性收集2017年06月至2019年12月就诊于广州市第一人民医院帕金森运动障碍疾病门诊或住院的200例PD患者病历资料,根据情绪障碍发生的先后及汉密尔顿抑郁和焦虑量表分为三组:以情绪障碍为首发症状(A组)、运动症状首发(B组)、无情绪障碍(C组),所有患者完善运动症状与非运动症状等相关量表。结果:情绪障碍发生率77%,而15%以情绪障碍为首发症状;相对比于B组,A组运动并发症发生率低(P<0.0167),主要表现为异动症发生率低,UPDRSⅠ评分高(P<0.05);相对比于C组,A组UPDRSⅢ评分高(P<0.0167),主要体现在UPDRSⅢ中轴部分(P<0.05);HAMA、HAMD、NMSS评分、UPDRSⅠ、疲劳-14评分高(P<0.05),SCOPA-AUT、FSS评分高(P<0.05),MMSE、MoCA低(P<0.05);UPDRSⅡ高(P<0.05),PDQ-39评分高和Schwab等级低(P<0.05)。结论:焦虑、抑郁在帕金森病患者中高发,情绪障碍首发的PD患者表现出更严重的运动症状与非运动症状,主要表现在躯体中轴部分运动障碍,运动并发症少,如异动症,更容易出现精神行为情绪异常、自主神经功能紊乱、认知功能下降和疲劳,严重影响患者的生活能力与生活质量。
Objective:To investigate the role of mood disorder as an initial symptom of Parkinson’s disease(PD).Methods:The medical records of 200 PD patients who visit the PD-associated Dyskinesia Clinic or hospitalized in Guangzhou First People’s Hospital between June 2017 and December 2019 were retrospectively collected.According to the timeline of mood disorder and the scores of Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA),all patients were divided into three groups:patients with mood disorder as an initial symptom(group A),with motor symptom as an initial symptom(group B),and without mood disorder(group C).The related scales of motor symptoms and non-motor symptoms were completed.Resultls:Mood disorder was found in 77%of the patients,presenting as an initial symptom in 15%.Compared with group B,patients in group A experienced fewer motor complications(P<0.0167),and in most of cases,had low incidence of dyskinesia and high UPDRS I score in most of cases(P<0.05).Compared with group C,patients in group A showed higher UPDRSⅢscore(P<0.0167),and in most of cases,presented higher axial UPDRSⅢsubscore(P<0.05),higher HAMA,HAMD,NMSS,UPDRS I and Fatigue-14 scores(all P<0.05),higher SCOPA-AUT and FSS scores(both P<0.05),lower MMSE and MoCA scores(both P<0.05),higher UPDRS II(P<0.05)and PDQ-39(P<0.05)scores,and lower Schwab grades(P<0.05).Conclusion:Anxiety and depression are highly prevalent in PD patients.PD patients with mood disorder as an initial symptom show more severe motor and non-motor symptoms,mainly manifested by motor disorders of the central body axis,with fewer motor complications such as dyskinesia.Mental behavioral abnormalities,autonomic dysfunction,cognitive decline and fatigue are more likely to occur in these patients,which seriously affects patients’daily living and quality of life.
作者
胡桂和
李蒙燕
陈浩博
周进
潘小平
Hu Guihe;Li Mengyan;Chen Haobo;Zhou Jin;Pan Xiaoping(Department of Neurology,Guangzhou First People’s Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510182,China;Department of Neurology,Guangzhou First People’s Hospital,Second Affiliated Hospital of South China University of Technology,Guangzhou,Guangdong 510182,China)
出处
《广州医科大学学报》
2020年第6期59-64,共6页
Academic Journal of Guangzhou Medical University
基金
广州市科技计划项目(2012J5100039,2016201604030018)
广州市卫生健康科技项目(20201A011004)。
关键词
帕金森病
情绪障碍
焦虑
抑郁
Parkinson’s disease
mood disorder
anxiety
depression
