年龄相关性黄斑变性患者认知功能和抑郁状态的临床分析

Clinical analysis of cognitive function and depressive states in patients with age-related macular degeneration

目的:比较年龄相关性黄斑变性(age-related macular degeneration,AMD)组和对照组患者认知障碍和抑郁症的风险差异。方法:采用前瞻性病例对照研究,分别记录2014-11/2016-08来院就诊的AMD患者和性别匹配的对照组患者简易精神状态检查表(minimum mental state examination,MMSE)和老年抑郁量表(the geriatric depression scale,GDS)得分,并行统计学分析。结果:AMD组和对照组患者共84例168眼纳入研究。基线资料比较,最佳矫正视力(best corrected visual acuity,BCVA)差异有统计学意义(F=8.953,P=0.004)。相同受教育情况两组MMSE得分差异均无统计学意义(P>0.05);总体认知障碍患病率比较,差异有统计学意义(χ~2=4.14,P=0.042)。两组患者GDS得分差异有统计学意义(F=5.852,P=0.018);抑郁总患病率及轻度抑郁患病率差异有统计学意义(χ~2=6.372,P=0.012;χ~2=5.674,P=0.017);中重度抑郁患病率差异无统计学意义(χ~2=0.672,P=0.412)。结论:AMD患者具有更高的抑郁症患病率,虽然基于受教育程度的分组MMSE得分差异不具有统计学意义,但总体较对照组更易患认知障碍。

AIM： To investigate the difference of cognitive impairment and depression between age-related macular degeneration（AMD）group and the control group patients. METHODS： A prospective case-control study was performed from November 2014 to August 2016 in the hospital for AMD patients and sex-matched control group. The Mini-Mental State Examination（MMSE）and the Geriatric Depression Scale（GDS）score of each patient were collected for statistical analyzing.RESULTS： There were total 84 cases（168 eyes）included in the study. The difference of visual acuity between the two group was statistically significant（F=8.953, P=0.004）by baseline data analyzing. There were no significant differences in MMSE scores between the two groups according to educational status（P〉0.05）, while the prevalence of cognitive impairment in each group was statistically significant（χ^2=4.14, P=0.042）. The difference of GDS scores, prevalence of total and mild depression between two groups were both statistically significant（F=5.852, P=0.018; χ^2=6.372, P=0.012; χ^2=5.674, P=0.017）. However, there was no statistically significant difference in the prevalence of moderate to severe depression（χ^2=0.672, P=0.412）.CONCLUSION： AMD patients have a higher prevalence of depression. Although MMSE score differences were not statistically significant in subgroup analysis by educational levels, AMD patients are more likely to have cognitive impairment overall.