帕金森病患者的抑郁状态及其相关因素分析

Depressive status in patients with Parkinson′s disease and its related factors

目的探讨帕金森病(PD)患者抑郁发生情况及其相关因素。方法连续纳入2019年3-6月在北京医院神经内科门诊就诊的100例帕金森病(PD)患者,采用贝克抑郁量表(BDI)、PD睡眠量表-2(PDSS-2)、8项PD调查表(PDQ-8)评估患者抑郁情绪、睡眠状况及健康相关生命质量,采用Spearman相关分析及多因素回归分析方法分析PD抑郁的相关因素;采用非参数检验,分析不同睡眠障碍域之间的差异。结果PD患者BDI评分为(9.9±8.6)分(0~44分),PDSS-2评分为(12.0±9.2)分(0~43分),PDQ-8评分为(6.4±6.0)分(0~24分)。检出抑郁状态者42例(42.0%),其中轻度者22例(52.4%),BDI评分为(13.0±1.9)分(10~15分);中度者14例(33.3%),BDI评分为(19.1±3.0)分(16~25分);重度者6例(14.3%),BDI评分为(33.3±6.4)分(28~44分)。多重线性相关性分析显示,BDI评分与PDQ-8评分(P<0.01)及PDSS-2评分(P=0.02)呈正相关。42例抑郁状态患者中,36例(85.7%)存在睡眠障碍,睡眠障碍域评分为(9.8±3.9)分,高于夜间运动症状域的(4.8±4.5)分、夜间PD非运动症状域的(4.1±3.3)分(均P<0.01)。PDQ-8中感到抑郁、觉得疾病导致家庭关系出现问题、注意力难以集中、感到难以和别人沟通4个维度评分与BDI评分呈正相关(均P<0.05)。结论抑郁是PD患者常见的非运动症状,伴抑郁状态的PD患者生命质量降低,且更易发生睡眠障碍。

Objective To investigate the accurrence and related factors of depression in patients with parkinson's disease(PD).Methods One hundred PD patients with Parkinson′s disease(PD)were enrolled in Department of Neurology in Beijing Hospital from March to June 2019.The depressive mood,sleep status and health-related quality of life of PD patients were evaluated by Beck Depression Scale(BDI),Parkinson′s Disease Sleep Scale 2(PDSS-2),and 8 items of Parkinson′s Disease Questionnaire(PDQ-8).Spearman correlation analysis and multivariate regression analysis were used to analyze the related factors of PD depression.Nonparametric test was used to analyze the differences between different sleep disorder domains in PD patients with depression.Results The total score of BDI in 100 PD patients ranged from 0 to 44,with an average of 9.9±8.6 points;the total score of PDSS-2 ranged from 0 to 43,with an average of 12.0±9.2;the total scores of PDQ-8 ranged from 0 to 24,with an average of 6.4±6.0 points.The detection rate of depression in 100 PD patients was 42.0%(42/100),and the total BDI score of 22 patients with mild depression ranged from 10 to 15 with an average of 13.0±1.9;the total BDI score of 14 patients with moderate depression ranged from 16 to 25,with an average of 19.1±3.0;the total BDI score of 6 patients with major depression ranged from 28 to 44 points,with an average of 33.3±6.4.The depression in PD patients was positively correlated with PDQ-8 score(t=8.908,P<0.01)and PDSS-2 score(t=2.286,P=0.02);and 85.7%(36/42)of PD patients with depression had sleep disturbance.The score of sleep disturbance domain of PD patients with depression(9.8±3.9)was higher than that of nocturnal motor symptom domain(4.8±4.5)and nocturnal PD non-motor symptom domain(4.1±3.3)(P<0.01).The scores of emotional health,relationship with loved ones,attention,communication ability dimensions of PDQ-8 were positively correlated with PD depression(P<0.05).Conclusion Depression is a common non-motor symptom of PD patients;and PD patients with depression suffer from reduced quality of life and are more prone to sleep disorders.