帕金森病患者脑深部电刺激术后焦虑改善率的影响因素研究

Study on influencing factors of anxiety improvement rate in patients with Parkinson's disease after deep brain stimulation

目的探讨帕金森病(PD)患者脑深部电刺激术(DBS)后焦虑改善率的影响因素。方法选取340例接受DBS的PD患者,对比患者术前术后汉密尔顿焦虑量表(HAMA)评分,统计术后HAMA评分改善率;并分析年龄、性别、病程、术前统一帕金森病评定量表(UPDRS)评分、术前PD患者生活质量问卷(PDQ-39)评分、UPDRS-3改善率、起病症状、文化程度、靶点、Hoehn-Yahr分期、术前HAMA评分对焦虑改善率的影响。结果本组患者DBS术后HAMA评分(12.32±7.69)比术前(16.91±8.78)明显降低(P<0.0001)。单因素分析显示,焦虑改善率高的患者与改善率低的患者UPDRS-3改善率及术前HAMA评分间的差异有统计学意义(P<0.01,P<0.0001)。Logistic回归分析显示,UPDRS-3改善率(OR 6.434,95%CI 1.531~31.04,P<0.05)及术前HAMA评分(OR 1.173,95%CI 1.102~1.259,P<0.0001)是焦虑改善率的影响因素。结论DBS可以改善PD病患者的焦虑症状;UPDRS-3改善率及术前HAMA评分与DBS后焦虑改善率密切相关。

Objective To study the influencing factors of anxiety improvement rate after deep brain stimulation(DBS)in Parkinson’s disease(PD).Methods 340 PD-DBS patients were enrolled in this study.The Hamilton Anxiety Scale(HAMA)scores before and after operation were assessed.The improvement rate of HAMA score was further calculated.The effects of age,gender,course of disease,preoperative Unified Parkinson’s Disease Rating Scale(UPDRS)score,preoperative quality of life questionnaire(PDQ-39)score,UPDRS-3 improvement rate,onset symptoms,education level,target,Hoehn-Yahr stage and preoperative HAMA score on anxiety improvement rate were analyzed.Results The HAMA score after DBS(12.32±7.69)was significantly lower than that before DBS(16.91±8.78)(P<0.0001).Univariate analysis showed that there were significant differences in UPDRS-3 improvement rate and preoperative HAMA score between patients with high anxiety improvement rate and patients with low anxiety improvement rate(P<0.01,P<0.0001).Logistic regression analysis showed that the improvement rate of UPDRS-3(OR 6.434,95%CI 1.531-31.04,P<0.05)and preoperative HAMA score(OR 1.173,95%CI 1.102-1.259,P<0.0001)were the influencing factors of anxiety improvement rate.Conclusions DBS can alleviate the anxiety symptoms of PD patients.The improvement rate of UPDRS-3 and preoperative HAMA score are closely related to the improvement rate of anxiety after DBS.