摘要
目的探讨老年帕金森病(PD)患者抑郁特征及相关因素分析。方法连续收集首都医科大学宣武医院1 138例老年PD患者,采用哈密尔顿抑郁17项量表(HAMD-17)评估抑郁情绪(HAMD-17 ≥14分诊断为存在抑郁);对比PD抑郁组与不伴抑郁组临床特征的差异性,采用Logistic回归模型分析PD患者发生抑郁的临床相关因素。结果 1 138例PD患者中,伴抑郁者233例,PD抑郁的发生率为20.5%,治疗率为6.0%(14例)。PD抑郁患者重度表现比例较高的主要症状为睡眠障碍101例(43.3%)、情绪低落57例(24.5%)、工作和兴趣减退49例(21%)。PD抑郁组与不伴抑郁组比较,女性比例更高(49.4%与36.3%)、认知评分更低[(25.56 ± 4.22)分与(27.07 ± 3.08)分]、出现冻结步态症状比例更高(51.0%与24.0%)、残疾出现率更高(87.1%与28.5%)(均P<0.05)。两组患者统一帕金森病量表(UPDRS)各部分评分相比,PD抑郁患者日常生活能力得分[(16.52 ± 8.71)分与(10.15 ± 5.48)分]、运动症状得分[(33.78 ± 19.48)分与(22.87 ±13.08)分]和治疗并发症的得分[2.0(0.0,6.0)分与0.0(0.0,2.0)分]均明显增高(P<0.05)。Logistic回归分析结果显示女性(OR=1.532,95%CI:1.073~2.187,P=0.019)、有残疾(OR=6.357,95%CI:4.399~9.186,P<0.001)、UPDRS中的日常生活活动评分(OR=1.093,95%CI:1.043~1.146,P<0.001)及运动并发症(OR=1.100,95%CI:1.014~1.193,P=0.022)是PD抑郁的独立危险因素。结论老年PD患者抑郁常表现为睡眠障碍、动力低下,且女性、出现运动并发症、残疾及日常生活能力下降可能是抑郁发生的独立危险因素。
Objective To investigate the characteristics and associated factors of depression in elderly patients with Parkinson's disease(PD).Methods A total of 1138 elderly PD patients from Xuanwu Hospital of Capital Medical University were consecutively enrolled.The Hamilton Depression 17-item Scale(HAMD-17)was used to diagnose depression(scores≥14).The depressive characteristics of PD patients with depression and those without depression were compared,and Logistic regression model was used to analyze the clinical risk factors of depression in PD patients.Results Among the 1138 PD patients,233 cases had depression.The incidence of depression in PD patients was 20.5%,and the treatment rate was only 6.0%(14 cases).The main symptoms of depression in PD patients included sleep disturbance(101 cases,43.3%),depression(57 cases,24.5%),work and interest loss(49 cases,21%).Compared to PD patients without depression,PD patients with depression were more likely women(49.4%Us 36.3%),and had lower cognitive scores[(25.56±4.22)scores us(27.07±3.08)scores],higher rate of freezing of gait(51.0%vs24.0%),higher incidence of disability(87.1%vs28.5%)(P<0.05).A comparison of each part of the unified Parkinson's disease rating scale(UPDRS)between the two groups revealed that the scores of activities of daily living[(16.52±8.71)scores vs(10.15±5.48)scores],the motor examination[(33.78±19.48)scores vs(22.87±13.08)scores]and the complications of therapy[2.0(0.0,6.0)scores vs0.0(0.0,2.0)scores]were higher in the PD patients with depression group than in the PD patients without depression group(P<0.05).Logistic regression analysis showed that women(OR=1.532,95%CI:1.073-2.187,P=0.019),disability(OR=6.357,95%CI:4.399-9.186,P<0.001),activities of daily living evaluated by UPDRS(OR=1.093,95%CI:1.043-1.146,P<0.001)and motor complications(OR=1.100,95%CI:1.014-1.193,P=0.022)were independent risk factors for PD depression.Conclusions Depression was common in PD patients and usually manifested as sleep disturbance and low motivation,women,motor complications,disability and decreased quality of daily living were.independent risk factors for depression.
作者
但小娟
刘佳
马敬红
周涌涛
顾朱勤
陈彪
Dan Xiaojuan;Liu Jia;Ma Jinghong;Zhou Yongtao;Gu Zhuqin;Chen Biao(Department of Neurology,Xuanwu Hospital of Capital Medical University,Beijing100053,China;Department of Geriatric,Xuanwu Hospital of Ca pital Medical University,Beijing100053,China;Chinese National HumanGenome Center,Beijing100176,China;Department of Neurobiology,Xuanwu Hospital of Capital Medical University,Beijing100053,China;National Clinical Research Center for Geriatric Disorders,Beijing100053,China;Advanced Innovation Center for Human Brain Protection,Ca pital Medical University,Beijing100069,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2021年第9期1121-1125,共5页
Chinese Journal of Geriatrics
基金
国家自然科学基金青年项目(81601109)
北京市医管局青苗计划(QML20180805)
国家重点研发计划(2018YFC1312001、2017YFC0840105)。
关键词
帕金森病
抑郁
危险因素
Parkinson's disease
Depression
Risk factors
