重症肌无力患者汉密尔顿抑郁量表评分分析

Analysis of scores of Hamilton depression rating scale in patients with myasthenia gravis

目的探讨重症肌无力(myasthenia gravis,MG)患者汉密尔顿抑郁量表(Hamilton depression rating scale,HDRS)评分情况及其影响因素分析。方法横断面研究2013-07—2015-03作者医院就诊的188例MG患者的临床资料和HDRS评分情况,并根据HDRS评分将其分为抑郁组和非抑郁组,分析两组MG患者的临床特点及其与HDRS评分间的关系。结果所纳入MG患者男女比例为1.02∶1,眼肌型重症肌无力(ocular myasthenia gravis,OMG)和全身型重症肌无力(generalized myasthenia gravis,GMG)的比例为1.2∶1,以OMG起病和以GMG起病患者的比例为6.2∶1,病程中位数为2年,四分位数间距为1.8年,平均量化重症肌无力评分(quantitative myasthenia gravis,QMG)为(6.7±2.3)分,平均HDRS评分为(8.7±3.4)分,并发抑郁者65例,未并发抑郁者123例。影响HDRS评分和抑郁发生的相关因素包括性别(P<0.01)、MG类型(P<0.01)、QMG得分(P<0.01)和美国重症肌无力协会(myasthenia gravis foundation of America,MGFA)分型(P<0.01)、有无甲状腺功能亢进(P<0.05)。结论影响MG患者HDRS评分和抑郁发生的相关因素包括性别、MG类型、QMG评分和MGFA分型、有无甲状腺功能亢进,充分认识其抑郁发生情况有利于更好地治疗MG。

Objective To investigate the scores of Hamilton depression rating scale（HDRS）in patients with myasthenia gravis（MG）and the related influencing factors.Methods A cross-sectional study of the clinical data and HDRS score was carried out in 188 MG patients who were admitted to Tangdu Hospital of the Fourth Military Medical University from July 2013 to March 2015.All the recruited patients were classified into the with depression group and the without depression group according to the HDRS score.The judge criterion of depression was as follow：HDRS scores of patients without depression were 0-9and patients with depression were above 9.The clinical features of the two groups and their relation with HDRS scores were analyzed.Results Among those MG patients,the male to female ratio was 1.02∶1.The ratio of ocular myasthenia gravis（OMG）to generalized myasthenia gravis（GMG）was 1.2∶1.The ratio of patients with onset symptom of OMG to patients with onset symptom of GMG was 6.2∶1.The median disease course was 2years and the interquartile range was 1.8years.The average quantitative myasthenia gravis（QMG）score was 6.7±2.3and the average HDRS score was 8.7±3.4.One hundred and twenty-three MG patients were not complicated with depression,while 65 cases were complicated with depression.Factors correlated with HDRS score and depression state included gender（P〈0.01）,clinical type of MG（P〈0.01）,QMG score（P〈0.01）,myasthenia gravis foundation of America（MGFA）classification（P〈0.01）,with or without hyperthyreosis（P〈0.05）.Conclusions Factors correlated with HDRS score and depression state include gender,clinical type of MG,QMG score and MGFA classification,sufficient understanding of the depression state in MG patients might be helpful for better treatment.