帕金森病抑郁与运动障碍的相关性分析

摘要

目的 探讨帕金森病(PD)的抑郁症状是否与运动障碍具有相关性.方法 采用回顾性病例对照研究,选取2008年4月～2015年8月在北京天坛医院神经内科门诊就诊的原发性PD患者800例,应用流行病调查中心抑郁量表(CES-D)评估所有患者的抑郁症状并分为抑郁组和非抑郁组.分别用一般情况调查表、统一帕金森病评定量表(UPDRS)、Hohen-Yahr分级和简易精神状态量表(MMSE)等对两组患者进行比较.应用Spearman分析帕金森病抑郁与运动障碍的相关性.应用Logistic回归分析探索PD抑郁的危险因素.结果 800例受试的PD患者中有362例患者出现了抑郁症状,占45.3％.抑郁组中Hoehn-Yahr分级大于2.5级的PD患者的比例高于非抑郁组,且抑郁组中UPDRSⅢ总分及其中震颤项目评分、强直项目评分、少动项目评分和步态姿势异常项目评分均高于非抑郁组患者(P＜0.01).PD患者CES-D评分与UPDRS运动分量表评分呈正相关(r=0.405,P＜0.01).Logistic回归分析提示,女性、UPDRS Ⅰ/Ⅱ分值高、步态姿势异常、运动障碍进展较快是PD抑郁的独立危险因素(P＜0.05).结论 抑郁是PD常见的非运动症状,PD抑郁的程度与患者运动障碍的程度相关.%Objective To investigate the correlation between depression and motor dysfunction in patients with Parkinson's disease (PD).Methods A retrospective case-control study was adopted in this study.800 PD patients in neurology clinic were enrolled in Beijing Tiantan Hospital from April 2008 to August 2015.All patients were assessed with Center for Epidemiologic Studies Depression Scale (CES-D) and divided into the depression group and the non-depression group.The two groups were compared with general data on demographics,unified Parkinson's disease rating scale (UPDRS),Hoehn-Yahr stage and mini-mental state examination (MMSE) scores respectively.The Spearman rank correlation coefficient was used to analyze the correlation between depression and motor dysfunction.Logistic regression was applied to explore risk factors of PD depression.Results 362 cases (45.3％) were identified as suffering from depression.In the depression group,the proportion of patients with Hoehn-Yahr stage greater than 2.5 was higher than that of the non-de pression group (PD).The UPDRS part Ⅲ scores,the UPDRS scores of rigidity items,tremor items and bradykinesia items of the depression group were significantly higher than those of the non-depression group (P ＜ 0.01).There was significant correlation between CES-D scores and UPDRS motor scores (r=0.405,P ＜ 0.01).Logistic regression analysis showed:female,higher score in UPDRS part Ⅰ/Ⅱ,gait and posture disturbance,faster progression of motor symptoms were risk factors of PD depression (P ＜ 0.05).Conclusion Depression is one of the common symptoms of PD and correlates with motor dysfunction.