帕金森病患者不同焦虑程度在汉密尔顿焦虑量表的结构差异

doi:10.3969/j.issn.1006-9771.2021.03.013

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (3): 325-328.doi: 10.3969/j.issn.1006-9771.2021.03.013

帕金森病患者不同焦虑程度在汉密尔顿焦虑量表的结构差异

蒋莹¹,房进平²,冯涛^1,^3,⁴,马惠姿¹()

^1.首都医科大学附属北京天坛医院神经病学中心运动障碍性疾病科，北京市 100070
^2.首都医科大学附属北京康复医院神经康复中心，帕金森病医学中心，北京市 100144
^3.国家神经系统疾病临床医学研究中心，北京市 100070
^4.北京脑重大疾病研究院帕金森病研究所，北京市 100070

收稿日期:2020-05-11 修回日期:2020-06-29 出版日期:2021-03-25 发布日期:2021-04-02
通讯作者: 马惠姿 E-mail:mahuizi1127@126.com
作者简介:蒋莹(1985-)，女，汉族，山东东营市人，博士，主治医师，主要研究方向：帕金森病发病机制、帕金森自主神经功能及运动障碍病等|马惠姿，女，硕士，副主任医师。
基金资助:
1. "十三五"国家重点研发计划项目(2017YFC1310204);北京市科委基金项目(Z171100000117013);国家自然科学基金青年项目(31600724);北京市自然科学基金青年项目(7174297);北京优秀青年骨干人才项目(2016000021469G210);国家自然科学基金面上项目(81571226);首都特色临床应用研究项目(Z171100001017041)

Structural Differences in Series Scores of Hamilton Anxiety Scale in Parkinson's Disease Patients

Ying JIANG¹,Jin-ping FANG²,Tao FENG^1,^3,⁴,Hui-zi MA¹()

^1.Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
^2.Center of Parkinson's Disease, Center of Neurological Rehabilitation, Beijing Rehabilitation Hospital of Capital Medical University, Beijing 100144, China
^3.China National Clinical Research Center for Neurological Disease, Beijing 100070, China
^4.Parkinson's Disease Center, Beijing Institute for Brain Disorder, Capital Medical University, Beijing 100070, China

Received:2020-05-11 Revised:2020-06-29 Published:2021-03-25 Online:2021-04-02
Contact: Hui-zi MA E-mail:mahuizi1127@126.com
Supported by:
National Key Research and Development Program of the 13th Five-Year Plan(2017YFC1310204);Beijing Science and Technology Commission Fund(Z171100000117013);National Natural Science Foundation of China (Youth)(31600724);Beijing Natural Science Foundation (Youth)(7174297);Beijing Outstanding Talents Training Foundation(2016000021469G210);National Natural Science Foundation of China (General)(81571226);Capital Clinical Application Research Program(Z171100001017041)

摘要/Abstract

摘要： 目的

探讨帕金森患者不同程度焦虑在汉密尔顿焦虑量表因子分方面的差异及变化趋势。

方法

2016年1月至2017年12月，北京天坛医院神经变性病科住院的原发性帕金森病患者180例，采集性别、年龄、病程，以及汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、统一帕金森病评定量表Ⅲ(UPDRSⅢ)、改良Hoehn-Yahr分期(H-Y分期)和简易精神状态检查(MMSE)评分。根据HAMA评分及临床症状将患者分为无焦虑组、可能焦虑组、焦虑组和明显焦虑组。比较各组一般资料、HAMA各因子分，评估HAMA与HAMD评分的相关性。

结果

随着焦虑程度加重，病程、UPDRSⅢ评分和抗帕金森药物最大改善率显著增加(F > 4.951, P < 0.001)，HAMD各因子分升高(F > 188.241, P < 0.001)，HAMA精神性因子分比例增加。HAMA评分与HAMD评分呈正相关(r = 0.665, P < 0.05)。

结论

帕金森病患者焦虑程度越重，精神性焦虑成分越多。

关键词: 帕金森病, 焦虑, 结构差异

Abstract: Objective

To explore the structural differences in series scores of Hamilton Anxiety Scale (HAMA) in Parkinson's disease patients with anxiety.

Methods

From January, 2016 to December, 2017, 180 inpatients with Parkinson's disease in Center for Neurodegenerative Disease, Beijing Tiantan Hospital were reviewed. Their age, gender, course of disease were recorded, and were assessed with HAMA, Hamilton Depression Scale (HAMD), unified Parkinson's Disease Rating Scale III (UPDRSIII)，Hoehn-Yahr stage and Mini-Mental State Examination (MMSE). They were divided into non-anxiety group, possible anxiety group, anxiety group and very anxiety group according to the scores of HAMA. The demographics, clinical data and series scores of HAMA were compared among these groups. The correlation between HAMA and HAMD were anlyzed.

Results

The course of disease, UPDRSIII scores and the most improvement ratio by drug increased with the severities of anxiety (F > 4.951, P < 0.001), as well as the series scores of HAMA (F > 188.241, P < 0.001); however, the proportion of psychogenic anxiety score increased with the severities of anxiety. The scores of HAMA correlated with the scores of HAMD (r = 0.665, P < 0.05).

Conclusion

The more serious the anxiety is, the more psychogenic are in Parkinson's disease patients.

Key words: Parkinson's disease, anxiety, structural differences

中图分类号:

R742.5

蒋莹,房进平,冯涛,马惠姿. 帕金森病患者不同焦虑程度在汉密尔顿焦虑量表的结构差异[J]. 《中国康复理论与实践》, 2021, 27(3): 325-328.

Ying JIANG,Jin-ping FANG,Tao FENG,Hui-zi MA. Structural Differences in Series Scores of Hamilton Anxiety Scale in Parkinson's Disease Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(3): 325-328.

图/表 2

参考文献 16

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项目	无焦虑组 (n = 46)	可能焦虑组 (n = 48)	焦虑组 (n = 62)	明显焦虑组 (n = 24)	F/χ²值	P值
性别(男/女, n)	26/20	27/21	35/27	15/9	0.957	0.812
年龄(岁)	63.17±11.26	62.04±10.40	62.02±10.12	61.29±13.05	0.186	0.905
病程(年)	3.95±2.95	6.69±4.93	6.47±4.59	8.88±5.50	7.038	< 0.001
H-Y分期	2.52±0.80	2.43±0.82	2.48±0.74	2.65±0.88	0.435	0.730
UPDRSⅢ	26.77±10.78	30.52±14.45	32.60±14.07	39.21±12.00	4.963	< 0.001
抗帕金森病药物最大改善率(%)	26.41±16.23	30.05±20.55	37.40±17.96	40.50±17.41	4.951	< 0.001
MMSE	25.60±4.77	23.23±8.03	24.18±5.97	24.13±5.79	0.510	0.679
起病形式(n)					0.214	0.999
震颤	20	20	26	8
运动迟缓	24	17	26	13
其他	2	11	10	3

项目	无焦虑组 (n = 46)	可能焦虑组 (n = 48)	焦虑组 (n = 62)	明显焦虑组 (n = 24)	F值	P值
HAMA躯体性	3.04±1.49	7.40±2.22^a	10.55±1.64^a,b	13.08±2.15^a,b,c	211.883	< 0.001
HAMA精神性	1.61±1.45	4.38±1.83^a	7.69±1.85^a,b	11.21±2.17^a,b,c	188.241	< 0.001
HAMA总分	4.65±1.57	11.75±2.06^a	18.24±1.84^a,b	24.29±2.16^a,b,c	746.770	< 0.001
HAMD总分	4.52±2.97	11.36±6.36^a	17.08±5.02^a,b	23.83±6.48^a,b,c	88.848	< 0.001

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帕金森病患者不同焦虑程度在汉密尔顿焦虑量表的结构差异

Structural Differences in Series Scores of Hamilton Anxiety Scale in Parkinson's Disease Patients

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