帕金森病患者病情程度及焦虑状态对伴发抑郁的影响

Effect of degree of disease condition and anxiety state on accompanying depression in patients with Parkinson disease

目的:比较帕金森病伴发抑郁与非伴发抑郁两组之间相关因素的异同,探讨帕金森病伴发抑郁的危险因素。方法:采用汉密顿抑郁量表(Hamiltondepressionscale,HAMD)评分将帕金森病患者划分为抑郁组与非抑郁组,对各组患者发病年龄、性别、病程、文化程度、Hoehn-Yahr(H-Y)、帕金森病统一评分量表(unitedParkinsondiseaseratingscale,UPDRS)日常生活及运动评分、临床痴呆评定量表(clinicaldementiaratingscale,CDR)、简易智能量表(mini-mentalstateexamination,MMSE)、汉密顿焦虑量表(,HAMA)等进行组间统计学分析,并进一步利用Logistic回归分析筛选出可能的危险因素。结果:抑郁组H-Y分级<2.5级26例(50.0%),≥2.5级26例(50.0%);非抑郁组<2.5级36例(59.0%),≥2.5级25例(41.0%),抑郁组UPDRS运动评分<28分20例(38.5%),≥28例32例(61.5%);非抑郁组<28分41例(67.2%),≥28例20例(32.8%)。焦虑的发生率抑郁组与非抑郁组差异有显著性意义(P<0.05)其他各项两组之间均差异无显著性意义;两组在痴呆的发生率上差异无显著性意义,但MMSE,CDR评分表明,抑郁组在痴呆的严重程度上明显重于非抑郁组;抑郁组与非抑郁组在HAMA评分分值7.58±4.09,5.33±1.46,即伴随焦虑的严重程度上差异有显著性意义;回归分析发现UPDRS运动评分(OR=3.

AIM:To study the similarities and differences of related factors between the depression and non-depression groups in patients with Parkinson disease (PD),so as to explore the risk factors accounting for the depression in PD patients. METHODS:All PD patients were divided into depression and non-depression groups according to the results of Hamilton depression scale(HAMD),then the differences between the two groups in some factors,such as mean age of onset,sex,disease course,educational level, grade of Hoehn-Yahr(H-Y),the daily living and motor scale of united Parkinson disease rating scale(UPDRS),the scale of clinical dementia rating scale(CDR),mini-mental state examination(MMSE) and Hamilton anxiety scale(HAMA) were statistically analyzed.Furthermore,Logistic regression analysis was used to screen the risk factors. RESULTS:There were 26 cases(50.0%) with H-Y grade < 2.5,26 cases(50.0%) ≥2.5 in the depression group, and there were 36 cases(59.0%) and 35(41.0%) respectively in the non-depression group.There were 20 cases(38.5%) with the motor score of UPDRS < 28,32 cases(61.5%)≥28 in the depression group,and there were 41 cases (67.2%) and 20(32.8%) respectively in the non-depression group,the incidence rate of anxiety between the two groups was significantly different(P< 0.05),and no obvious difference was found in other factors between the two groups.There was no significant difference in the incidence rate of dementia between the two groups.The scores of MMSE and CDR disclosed that there was more severe dementia in the depression group than in the non-depression group.The scores of HAMA(severity of anxiety) in the depression group(7.58±4.09) and non-depression group(5.33±1.46) were significantly different. Logistic regression analysis showed that the motor scale of UPDRS(OR=3.523) and anxiety(OR=1.496) could be the risk factors in PD patients with depression. CONCLUSION:The severity of PD and anxiety are the risk factors accounting for the depression in PD patients.