帕金森病伴发抑郁症的危险因素及治疗效果观察

The related factors and treatment effect observation of Parkinson disease accompanied by depression

目的探讨帕金森病(PD)伴发抑郁症的危险因素, 并评价临床心理干预的治疗效果。方法选择2016年3月至2020年3月保定涿州宝石花医院收治的200例PD患者, 依据汉密尔顿抑郁量表24项版(HAMD-24)评分分为病例组(PD伴抑郁症, HAMD-24评分≥ 8分, 98例)和对照组(PD不伴抑郁症, HAMD-24评分<8分, 102例)。应用单因素分析和多因素回归分析筛选PD伴发抑郁症的危险因素。将病例组按随机数字表法分为心理治疗组(49例)和非心理治疗组(49例), 比较两组治疗前后抑郁程度、生命质量及睡眠质量的差异。结果 PD伴发抑郁症发生率为49.0%(98/200);多因素分析结果显示, Hoehn-Yahr分级量表(H-Y分级)、匹兹堡睡眠质量指数(PSQI)评分及婚姻状况异常是PD伴发抑郁症的危险因素(P<0.05), 受教育年限是PD伴发抑郁症的保护因素(P<0.05)。心理治疗组和非心理治疗组治疗后HAMD-24评分及PSQI评分均较治疗前降低, 并且心理治疗组治疗后HAMD-24评分和PSQI评分均低于非心理治疗组[(11.78 ± 2.94)分比(15.55 ± 3.91)分、(5.18 ± 1.05)分比(5.74 ± 1.12)分], 差异均有统计学意义(P<0.05)。心理治疗组治疗后在健康生存质量测评表(HRQOL)的五个维度评分方面均高于非心理治疗组, 差异均有统计学意义(P<0.05)。结论 PD伴发抑郁症受多因素影响, 加强心理治疗有助于减轻PD伴发抑郁症患者的抑郁程度, 并能提高患者睡眠质量和生命质量。

Objective To explore the related factors and treatment effect observation of Parkinson disease(PD)accompanied by depression.Methods Two hundred patients with PD admitted to Baoding Zhuozhou Baoshihua Hospital from March 2016 to March 2020 were selected.According the scores of Hamilton depression inventory 24-item version(HAMD-24),they were divided into the case group(PD accompanied by depression,HAMD-24≥8 scores,98 cases)and the control group(PD without depression,HAMD-24<8 scores,102 cases).Single factor analysis and multivariate regression analysis were used to analyze the influencing factors of PD accompanied by depression.The patients in the case group were divided into psychological treatment group and non-psychological treatment group by random number table method,each group with 49 cases.The differences in depression degree,quality of life and sleep quality before and after treatment between the two groups were compared.Results The incidence rate of PD accompanied by depression was 49.0%(98/200).The multivariate regression analysis showed that the Hoehn-Yahr classification(H-Y classification),Pittsburgh Sleep Quality Index(PSQI)scores and abnormal marital status were the influence factors of PD accompanied by depression(P<0.05);the education years was the protective factor of PD accompanied by depression(P<0.05).After treatment,the scores of HAMD-24 and PSQI in the psychological treatment group and the non-psychological treatment group were decreased,and the scores of HAMD-24 and PSQI in the psychological treatment group were lower than those in the non-psychological treatment group:(11.78±2.94)scores vs.(15.55±3.91)scores,(5.18±1.05)scores vs.(5.74±1.12)scores,the differences were statistically significant(P<0.05).After treatment,the improved degree of scores of five item of HAMD-24 in the psychological treatment group were higher than those in the non-psychological treatment group,the differences were statistically significant(P<0.05).Conclusions PD accompanied by depression is affected by multiple factors.Strengthening psychological treatment can reduce the degree of depression in patients with PD accompanied by depression and improve the quality of sleep and life.