帕金森病进展速度与抑郁、睡眠障碍的相关性分析

Correlation between progression of Parkinson disease and depression and sleep disorders

目的探讨帕金森病(PD)进展速度与其抑郁、睡眠障碍的相关性,以及PD抑郁、睡眠障碍的危险因素。方法选取83例PD患者,分别评估其抑郁、睡眠、焦虑、认知和生活能力情况。分析PD进展速度与抑郁和睡眠障碍的相关性,并采用回归模型分析PD抑郁与睡眠障碍的危险因素。结果PD进展速度与帕金森统一量表(UPDRS)Ⅰ、Ⅱ、Ⅲ部分、霍亚分期量表(H-Y)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠量表(PSQI)、汉密尔顿焦虑量表(HAMA)评分呈正相关(P<0.05),与简易智能精神状态量表(MMSE)和巴式指数量表(BI)评分呈负相关(P<0.05);HAMD和PSQI评分与UPDRS-Ⅱ、Ⅲ、Ⅳ、HAMA和H-Y评分呈正相关(P<0.05),与BI评分呈负相关(P<0.05),HAMD和PSQI评分呈正相关(P<0.05);H-Y、HAMA评分与PD抑郁发生的风险独立相关(P<0.001);UPDRS-Ⅳ、HAMA评分与PD患者睡眠障碍发生的危险独立相关(P<0.05)。结论PD焦虑、运动障碍和治疗并发症合并抑郁或睡眠障碍可加快PD进展速度,应在临床实践中常规评估并及早进行干预。

Objective The purpose of this study was to investigate the relationship between the progression rate of Parkinson disease(PD)and depression,sleep disorders,and the risk factors for PD depression and sleep disorders.Methods Eighty-three patients with PD were enrolled and evaluated for depression,sleep,anxiety,cognition,and viability.The correlations between PD progression rate and depression and sleep disorders were analyzed,and regression models were used to analyze risk factors for PD-related depression and sleep disorders.Results PD progression rate was positively correlated with the Unified Parkinson’s Disease Rating Scale(UPDRSⅠ,Ⅱ,andⅢ),Hoehn-Yahr(H-Y)scale score,Hamilton Depression Scale(HAMD),Pittsburgh Sleep Quality Index(PSQI),and Hamilton Anxiety Scale(HAMA)scores(P<0.05)and negatively correlated with the Mini-Mental State Examination(MMSE)and Barthel Index(BI)scores(P<0.05).The HAMD and PSQI scores were positively correlated with UPDRSⅡ,Ⅲ,Ⅳ,HAMA and H-Y scores(P<0.05)and negatively correlated with BI scores(P<0.05).HAMD and PSQI scores were positively correlated with each other(P<0.05).H-Y and HAMA were independently associated with the risk of depression in patients with PD(P<0.001).The UPDRS-IV and HAMA scores were independently associated with the risk of sleep disorders in patients with PD(P<0.05).Conclusion Anxiety,dyskinesia,and treatment complications-combined with depression or sleep disorders-can aggravate PD progression.Consequently,routine evaluations and early intervention should be performed in clinical settings.