帕金森病伴发抑郁和焦虑及其相关因素研究

摘要

Objective To investigate the depression and anxiety in patients with Parkinson's disease (PD) and the related factors. Methods A total of 83 patients with PD diagnosed from April 2015 to April 2016 in the Neurology Department of Renmin Hospital of Wuhan University were evaluated by Beck Depression Inventory (BDI) and Beck Anx-iety Inventory (BAI). The factors of gender, age, disease duration, onset-age, years of education, Minimum Mental state Examination (MMSE) score, Montreal Cognitive Assessment (MoCA) score, Unified Parkinson Diease Rating Scale (UP-DRS)Ⅲscore, Hoehn&Yahr staging, 1evodopa equivalent doseswere (LED) were included in the study. Single factor analysis and stepwise multiple linear regression analysis were used to analyze the correlation factors. Results The inci-dence of depression and anxiety in 83 patients with PD were 45.8%and 41.0%, respectively. There were significant differ-ences between depression group and non-depression group, as well as anxiety group and non-anxiety group, in age, on-set-age, years of education, LED (mg/d) (P<0.05). By stepwise multiple linear regression analysis we found that BDI score of PD patients was negatively correlated with age (r=-0.280, P=0.01), years of education (r=-0.237, P=0.03) and LED (mg/d) (r=-0.222, P=0.04), and the BAI score of PD patients was negatively correlated with age (r=-0.295, P=0.007), and LED (mg/d) (r=-0.328, P=0.003). Conclusion PD patients are often accompanied by depression and anxi-ety. Its occurrence was closely related with the factors of age, educated-years, and the use of anti-Parkinson's disease drugs. It was the result of the interaction of endogenous biological factors and exogenous psychosocial factors.%目的：调查帕金森病(PD)伴发抑郁、焦虑的状况及其相关因素。方法对2015年4月至2016年4月在武汉大学人民医院神经内科就诊的83例PD患者进行调查分析，采用贝克抑郁自评量表(BDI)及贝克焦虑自评量表(BAI)对其进行评定，将性别、疾病临床类型、年龄、病程、起病年龄、受教育年限、MMSE评分、MoCA评分、UPDRSⅢ评分、Hoehn＆Yahr分级、左旋多巴等效剂量(LED)纳入研究，对相关因素采用单因素分析及逐步多元线性回归分析。结果83例PD患者中抑郁发生率为45.8%，焦虑发生率为41.0%；PD抑郁组与非抑郁组之间及PD焦虑组与非焦虑组之间年龄、起病年龄、受教育年限、LED (mg/d)比较差异均有统计学意义(P<0.05)；经逐步多元线性回归分析发现，PD患者的BDI评分与年龄(r=-0.280，P=0.01)、受教育年限(r=-0.237，P=0.03)及LED (mg/d)(r=-0.222，P=0.04)呈负相关，PD患者BAI评分与年龄(r=-0.295, P=0.007)、LED (mg/d)(r=-0.328, P=0.003)呈负相关。结论 PD患者常伴发抑郁及焦虑，其发生与患者年龄、受教育年限、抗帕金森药物的使用密切相关，是内源性的生物学因素、外源性的心理社会因素共同作用的结果。