帕金森病患者伴发焦虑障碍的危险因素分析

Risk Factors for Parkinson’s Disease Patients with Anxiety Disorder

目的分析帕金森病(PD)患者伴发焦虑障碍的危险因素。方法收集2019年11月至2022年6月在郑州大学第一附属医院神经内科确诊的186例PD患者及50例同期健康体检者的临床资料,将PD患者纳入PD组,健康体检者纳入健康组,进行组间差异比较。根据汉密尔顿焦虑量表(HAMA)评分将PD患者分为无焦虑组(35例)和有焦虑组(151例),采用二元logistic回归分析PD伴发焦虑障碍的危险因素。结果PD组与健康组C反应蛋白(CRP)、同型半胱氨酸(Hcy)、中性粒细胞百分比比较差异有统计学意义(P<0.05)。有焦虑组和无焦虑组病程、帕金森病自主神经功能评定量表(SCOPA-AUT)的消化系统评分、统一帕金森病评定量表(MDS版)第三部分(MDS-UPDRSⅢ)评分、中性粒细胞百分比、维生素B 12水平比较差异有统计学意义(P<0.05)。PD伴发焦虑障碍的危险因素包括病程(OR=1.018,95%CI:1.002~1.035,P=0.028)、SCOPA-AUT的消化系统评分(OR=1.209,95%CI:1.043~1.401,P=0.012)和中性粒细胞百分比(OR=1.050,95%CI:1.001~1.101,P=0.044)。结论长病程、高中性粒细胞百分比以及频繁发生消化障碍的PD患者需要警惕伴发焦虑障碍的风险。

Objective To analyze the risk factors of anxiety disorder in patients with Parkinson’s disease(PD).Methods The clinical data of 186 PD patients diagnosed in the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from November 2019 to June 2022 and 50 healthy people during the same period were collected.The PD patients were selected as PD group and the healthy people were selected as healthy group.And the differences between two groups were compared.PD patients were divided into absence of anxiety group(35 cases)and presence of anxiety group(151 cases)based on assessment of the Hamilton anxiety scale(HAMA).The differences between the groups were analyzed.Binary logistic regression analysis was used to analyze the risk factors for PD anxiety disorder.Results There were statistical differences in C-reactive protein(CRP),homocysteine(Hcy)and neutrophil percentage between PD group and healthy group(P<0.05).Disease duration,digestive system score of the scales for outcomes in Parkinson’s disease-autonomic(SCOPA-AUT),movement disorder society-unified Parkinson disease rating scaleⅢ(MDS-UPDRSⅢ)score,neutrophil percentage and vitamin B 12 level in absence of anxiety group and presence of anxiety group were statistically significant(P<0.05).The risk factors of anxiety disorder associated with PD were disease duration(OR=1.018,95%CI:1.002-1.035,P=0.028),digestive system of SCOPA-AUT score(OR=1.209,95%CI:1.043-1.401,P=0.012),neutrophil percentage(OR=1.050,95%CI:1.001-1.101,P=0.044).Conclusion PD patients with longer disease duration,higher neutrophil percentage and higher occurrences of digestive dysfunction should be alert to the risk of anxiety disorder.