帕金森病合并精神障碍的临床研究

The clinical study on mental disorders in Parkinson's disease

目的:了解帕金森病(PD)合并精神障碍的发生率及临床特点,分析其影响因素和可能的原因。方法:选取300例确诊为帕金森病的门诊患者,采用UPDRSⅢ评定患者开期的运动功能,Hoehn-Yahr分级判定患者病情严重程度,采用阴性症状量表(SANS)和阳性症状量表(SAPS)评价患者精神症状的严重程度。结果:300例PD患者中,175例(58.3%)出现较为严重的阴性精神症状,其中缺乏社交兴趣171例(57.0%),情感平淡或迟钝164(54.6%),意志缺乏103(34.3%),经分析PD患者阴性精神症状与UPDRSⅢ评分、Hoehn-Yahr分级、年龄、左旋多巴每日剂量相关,与性别无关。18例(6.0%)出现较为严重的阳性精神症状,其中幻觉16例(5.3%),最常见于使用安坦(28.75%)的患者。结论:PD患者精神障碍较为常见,主要表现为缺乏社交兴趣、情感平淡或迟钝、意志缺乏、幻觉等,阴性精神症状与UPDRSⅢ评分、Hoehn-Yahr分级、年龄、左旋多巴每日剂量相关,与性别无关。

Objective： To observe the occurrence and the characteristic of mental disorders in Parkinson’s disease, the clinical features and the impacting factors. Methods： 300 consecutive out-patients with PD were assessed by means of the Unified Parkinsong Disease Rating Scale Ⅲ（ UPDRSⅢ ） and were staged by the Hoehn and Yahr system （H/Y）. The levels of mental disorders were assessed by Scale for the Assessment of Negative Symptoms （SANS） and Scale for Assessment of Positive Symptoms （SAPS）. Results： Severe negative symptoms were seen in 175 （58.3 % ） PD patients, including 171 patients （57.0%） lack of interest in public relations, 164 patients（54.6% ） with plain or clumsy emotion, 103 patients （34.3 % ） with will lack. Using stepwise liner regression and partial correlation, we found negative symptoms were correlated with UPDRS Ⅲ, Hoehn-Yahr, age and the daily dosage of L-dopa, independent of gender. Severe positive symptoms were seen in 18 （6.0%） PD patients. Illusions were the most common symptoms and often occurred in patients using Artane （28.75%）. Conclusion： Mental disorders are common in Parkinsong disease, and the main symptoms include the lack of interest in public relations, plain or clumsy emotion, will lack and illusion. Negative symptoms were correlated with UPDRS, Hoehn-Yahr, age and the daily dosage of L-dopa, but were independent of gender.