帕金森病患者不同程度抑郁在汉密尔顿抑郁量表的结构差异

doi:10.3969/j.issn.1006-9771.2021.07.015

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (7): 829-833.doi: 10.3969/j.issn.1006-9771.2021.07.015

帕金森病患者不同程度抑郁在汉密尔顿抑郁量表的结构差异

马惠姿¹,房进平²,冯涛^1,^3,⁴,蒋莹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:2021-05-25 出版日期:2021-07-25 发布日期:2021-07-28
通讯作者: 蒋莹 E-mail:jiangying0546_6611@163.com
作者简介:马惠姿(1962-),女,汉族,北京市人,硕士,副主任医师,主要研究方向：帕金森病、焦虑抑郁及运动障碍病等。
基金资助:
1.国家自然科学基金青年项目(31600724);2.北京市自然科学基金青年项目(7174297);3.北京市中共组织部优秀青年骨干人才项目(2016000021469G210);4. "十三五"国家重点研发计划项目(2016YFC1306501);4. "十三五"国家重点研发计划项目(No. 2017YFC1310204);4. "十三五"国家重点研发计划项目(No. 2017YFC1310203);4. "十三五"国家重点研发计划项目(No. 2017YFC1310202);4. "十三五"国家重点研发计划项目(No. 2017YFC1310201);5. 国家自然科学基金面上项目(81571226);5. 国家自然科学基金面上项目(81771367);6.北京市科委基金项目(Z151100003915150);6.北京市科委基金项目(Z171100000117013);7.首都特色临床应用研究项目(Z171100001017041)

Structural Differences of Depression for Patients with Parkinson's Disease Using Hamilton Depression Scale

MA Hui-zi¹,FANG Jin-ping²,FENG Tao^1,^3,⁴,JIANG Ying¹()

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:2021-05-25 Published:2021-07-25 Online:2021-07-28
Contact: JIANG Ying E-mail:jiangying0546_6611@163.com
Supported by:
National Natural Science Foundation of China(31600724);Beijing Natural Science Foundation(7174297);Beijing Outstanding Talents Training Foundation(2016000021469G210);National Key Research and Development Program of the 13th Five-Year Plan(2016YFC1306501);National Key Research and Development Program of the 13th Five-Year Plan(No. 2017YFC1310204);National Key Research and Development Program of the 13th Five-Year Plan(No. 2017YFC1310203);National Key Research and Development Program of the 13th Five-Year Plan(No. 2017YFC1310202);National Key Research and Development Program of the 13th Five-Year Plan(No. 2017YFC1310201);National Natural Science Foundation of China(General)(81571226);National Natural Science Foundation of China(81771367);Beijing Science and Technology Commission Fund(Z151100003915150);Beijing Science and Technology Commission Fund(Z171100000117013);Capital Clinical Application Research Program(Z171100001017041)

摘要/Abstract

摘要：

目的探讨帕金森病不同程度抑郁患者汉密尔顿抑郁量表(HAMD)各因子分的差异及变化趋势。

方法 2017年6月至2018年3月,选择北京天坛医院运动障碍科住院的原发性帕金森病患者168例,收集患者性别、年龄、病程、HAMD评分、统一帕金森综合评分量表Ⅲ (UPDRS Ⅲ)评分、改良Hoehn-Yahr分级(H-Y分级)、简易精神状态检查(MMSE)评分、抗帕金森药物最大改善率等临床资料。根据HAMD评分分为无抑郁组(n = 61)、轻度抑郁组(n = 68)和中度抑郁组(n = 39)。比较各组HAMD各因子分差异。

结果除轻度抑郁组日夜变化外,各因子分均随抑郁程度加重而显著增加(F > 10.546, P < 0.001);焦虑/躯体化所占比例下降,认知障碍、阻滞所占比例增加。

结论随着抑郁程度加重,帕金森病患者抑郁结构发生变化,焦虑/躯体化比例下降,认知障碍、阻滞比例增加。

关键词: 帕金森病, 抑郁, 汉密尔顿抑郁量表, 结构差异性

Abstract:

Objective To explore the structural differences and the trend in series scores of Hamilton Depression Scale (HAMD) in patients with Parkinson's disease (PD).

Methods From June, 2017 to March, 2018, 168 PD patients from Beijing Tiantan Hospital were reviewed. Their genders, ages, courses of disease, Hamilton Depression Scale (HAMD) scores, unified Parkinson's disease rating scale III (UPDRS III) scores,Hoehn-Yahr stage and Mini-Mental State Examination (MMSE) scores, the most improvement ratios by PD drug and other clinical data were collected. The patients were divided into non-depression group (n = 61), mild depression group (n = 68) and moderate depression group (n= 39) according to the HAMD scores. The series scores of HAMD among the groups were compared.

Results The factor scores all increased with depression exacerbating (F > 10.546, P < 0.001), except day and night change in the mild depression group, while the proportion of anxiety/somatization score decreased, and the proportion of cognitive disorder and retardant scores increased.

Conclusion The depression structure changes in PD patients with depression exacerbating, which means decrease of anxiety/somatization and increase of cognitive disorder and retardant.

Key words: Parkinson's disease, depression, Hamilton Depression Scale, structural differences

中图分类号:

R742.5

马惠姿,房进平,冯涛,蒋莹. 帕金森病患者不同程度抑郁在汉密尔顿抑郁量表的结构差异[J]. 《中国康复理论与实践》, 2021, 27(7): 829-833.

MA Hui-zi,FANG Jin-ping,FENG Tao,JIANG Ying. Structural Differences of Depression for Patients with Parkinson's Disease Using Hamilton Depression Scale[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(7): 829-833.

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项目	无抑郁组(n = 61)	轻度抑郁组(n = 68)	中度抑郁组(n = 39)	F/χ²值	P值
性别(男/女, n)	34/27	33/35	28/11	0.064	0.969
年龄(岁)	63.61±9.99	61.74±11.50	60.03±11.97	1.276	0.282
病程(年)	4.91±3.47	6.53±4.62^a	7.74±4.44^a	5.732	0.004
H-Y分期	2.39±0.69	2.42±0.84	2.72±0.92	2.265	0.108
UPDRSⅢ评分	29.68±30.96	32.44±13.61	36.84±14.86	1.287	0.279
抗帕金森病药物最大改善率(%)	28.63±15.78	37.60±20.18^a	37.58±18.11^a	4.707	0.003
MMSE评分	22.50±7.77	24.41±6.51	21.67±7.29	2.123	0.230
起病形式(n)				0.048	1.000
震颤	26	28	13
运动迟缓	29	24	23
其他	6	16	3

项目	无抑郁组(n= 61)	轻度抑郁组(n= 68)	中度抑郁组(n= 39)	F值	P值
焦虑/躯体化	2.05±1.347	4.40±1.405^a	6.10±1.971^a,b	88.010	< 0.001
体质量减轻	0.18±0.466	0.53±0.782^a	0.85±0.904^a,b	10.546	< 0.001
认知障碍	0.13±0.340	0.69±0.950^a	2.56±2.437^a,b	41.366	< 0.001
日夜变化	0.05±0.284	0.13±0.383	0.69±0.922^a,b	19.282	< 0.001
阻滞	0.44±0.742	2.88±1.511^a	4.74±1.499^a,b	140.850	< 0.001
睡眠障碍	0.75±1.011	3.01±2.033^a	4.51±1.571^a,b	69.062	< 0.001
绝望感	0.85±1.138	2.90±1.426^a	4.46±1.411^a,b	92.942	< 0.001

帕金森病患者不同程度抑郁在汉密尔顿抑郁量表的结构差异

Structural Differences of Depression for Patients with Parkinson's Disease Using Hamilton Depression Scale

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