中国帕金森病患者抑郁情绪发生率的Meta分析

Incidence of Depression among Parkinson’s Disease in China:A Meta-Analysis

目的对中国帕金森病患者(Parkinson’s Disease,PD)抑郁情绪发生率进行Meta分析。方法通过系统检索CNKI、VIP、万方、PubMed、Web of Science、Embase等中英文数据库,纳入建库至2019年有关中国PD患者抑郁情绪的调查研究,由2位研究者背对背按照纳入排除标准独立筛选文献、提取资料并应用美国卫生保健质量和研究机构横断面研究文献质量评价标准评价文献质量,根据异质性检验结果,采用Stata 12.0软件随机效应模型对数据进行合并分析。结果最终纳入37篇文献,共计7482例PD患者,男性4394例,女性3088例,抑郁情绪检出率的合并值为43.0%[95%CI(0.370,0.490)]。亚组分析显示样本量<150例的研究抑郁发生率为47.7%[95%CI(0.413,0.542)],样本量≥150者抑郁发生率为34.3%[95%CI(0.254,0.432)];不同的评估工具抑郁发生率分别为汉密尔顿抑郁量表43.0%[95%CI(0.359,0.501)]、流调中心抑郁量表38.1%[95%CI(0.301,0.461)]、Zung抑郁自评量表41.0%[95%CI(0.163,0.657)]、贝克抑郁问卷46.0%[95%CI(0.353,0.567)];男性PD患者抑郁发生率为40.0%[95%CI(0.312,0.489)],女性抑郁发生率为43.0%[95%CI(0.340,0.519)];病程≤5 y的PD患者抑郁发生率为43.2%[95%CI(0.330,0.533)],病程>5 y者抑郁发生率为44.4%[95%CI(0.362,0.527)];平均起病年龄≥60岁的PD患者抑郁发生率为40.2%[95%CI(0.266,0.538)],平均起病年龄<60岁者抑郁发生率为45.3%[95%CI(0.335,0.570)];UPDRSⅢ得分>25分者抑郁发生率为45.4%[95%CI(0.441,0.497)],得分≤25分者抑郁发生率为39.1%[95%CI(0.261,0.521)];PD患者轻度抑郁发生率为42.1%[95%CI(0.303,0.538)],中度抑郁发生率为22.7%[95%CI(0.160,0.293)],重度抑郁发生率为7.4%[95%CI(0.049,0.100)]。结论PD患者抑郁情绪发生率较高,急需医护人员对各时期PD患者的情绪状态早评估、早诊断、早干预。

Objective To analyze the rate of depression among Chinese Parkinson’s disease patients by Meta-analysis.Methods CNKI,VIP,Wanfang,PubMed,Web of Science and Embase databases were searched systematically.The studies focus on depression of Parkinson’s disease patients in China from the year of establishment to 2019 were collected.Two researchers independently screened literature,extracted data and applied the standard of Agency for Healthcare Research and Quality to evaluate the quality of literatures.According to the results of heterogeneity test,the data were analyzed by Stata 12.0 software using random effect model.Results A total of 7842 PD patients,4394 males and 3088 females,were included in 37 studies.The combined value of depression detection rate was 43.0%[95%CI(0.370,0.490)].Subgroup analysis showed that the incidence of depression in the study with sample size<150 was 47.7%[95%CI(0.413,0.542)],and the incidence of depression in the study with sample size≥150 was 34.3%[95%CI(0.254,0.432)],respectively.The prevalence rates of depression with assessment tools were different,Hamilton Depression Rating for Depression 43.0%[95%CI(0.359,0.501)],Center for Epidemiologic Studies Depression Scale 38.1%[95%CI(0.301,0.461)],Self-Rating Depression Scale 41.0%[95%CI(0.163,0.657)],Beck Depression Inventory 46.0%[95%CI(0.353,0.567)].The incidence of depression in female PD patients was 43.0%[95%CI(0.340,0.519)],43.2%[95%CI(0.330,0.533)]in male.The incidence of depression was 43.2%[(95%CI(0.330,0.533)],among patients disease duration≤5 years,44.4%[(95%CI(0.362,0.501)]in patients with PD whose disease duration more than 5 years.The incidence of depression was 40.2%[95%CI(0.226,0.538)]in PD patients whose onset age≥60 years,45.3%[95%CI(0.335,0.570)]in PD patients whose onset age<60 years.The incidence of depression was 45.4%[95%CI(0.441,0.497)]in patients with UPDRSIII score>25,39.1%[95%CI(0.261,0.521)]in those with score≤25.42.1%[95%CI(0.303,0.538)]PD patients with mild depression,22.7%[95%CI(0.160,0.293)]with moderate depression and 7.4%[95%CI(0.049,0.100)]with severe depression.Conclusion The incidence of depression is high in PD patients.The emotion of PD patients in every stage need evaluate,diagnose and cure earlier.