新疆维吾尔族和汉族帕金森病患者心理健康状态分析

摘要

目的：探讨新疆维吾尔族与汉族帕金森病（Parkinson’s disease，PD）患者心理健康状态差异性及 PD患者抑郁的影响因素。方法选择130例 PD 患者（PD 组）（汉族80例，维族50例）和80例健康成人（正常对照组），通过完成基本情况调查表、临床症状评定量表（UPDRS）及 Hoehn-Yahn（H-Y）评分、广泛性焦虑量表-7项（GAD-7）和病人健康问卷抑郁量表-9项（PHQ-9），均进行空腹血糖（FBG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-c）、低密度脂蛋白（LDL-c）、纤维蛋白（FIB）、尿酸（UA）、同型半胱氨酸（Hcy）及 C-反应蛋白（CRP）水平检测，比较维吾尔族和汉族 PD 患者各种评分及实验指标差异性，进一步分析 PD 患者抑郁的影响因素。结果维吾尔族 PD、汉族 PD 患者与正常对照组焦虑发生率分别为60．00％、56．25％和6．25％；3组抑郁发生率分别为48．00％、57．50％和7．50％。维吾尔族 PD 组、汉族 PD 组与正常对照组 GAD-7总评分分别为（11．16±5．89）分、（9．84±5．62）分、（3．75±2．94）分，3组 PHQ-9总评分分别为（9．60±5．64）分、（8．55±5．65）分、（3．50±1．99）分，维吾尔族 PD 组、汉族 PD 组分别与正常对照组在焦虑抑郁发生率及 GAD-7和 PHQ-9总评分方面比较差异有统计学意义（P ＜0．05），而维吾尔、汉族 PD 患者比较差异无统计学意义（P ＞0．05）；相关性分析显示 PHQ-9总分与 H-Y分期、GAD-7呈正相关（r 分别为0．012和0．633，P ＜0．05），与 UA 呈负相关（r 为－0．299，P ＜0．05），多元回归分析显示 PHQ-9总分与 GAD-7和 UA 有相关性（β分别为0．631和0．012，P ＜0．05）。结论PD 患者焦虑及抑郁的发生率及严重程度明显高于正常人群，但维、汉族 PD 患者心理健康状态相比无明显差异，PD 患者的抑郁影响因素有 GAD-7和 UA，焦虑程度越重，UA 水平越低，PD 患者越易发生抑郁。%Objective To investigate the difference of mental health status in patients with Parkinson′s dis-ease (PD)of Uygur and Han in Xinjiang,and further to analyze the influence factors of the mental health status of depression in patients with PD.Methods 130 PD patients (80 cases of Han vs50 cases of Uygur) and and 80 cases of healthy adults (normal control group),were enrolled into the study.All of the partici-pants were asked to finish the questionnaires,such as the basic information,the Unified Parkinson′s dis-ease Rating Scale (UPDRS)and Hoehn & Yahn (H-Y)scale,the generalized anxiety scale-7 (GAD-7), the patient health questionnaire depression scale-9 (PHQ-9),and to be taken fasting Venous blood sample for detecting glucose (FBG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein choles-terol (HDLc),low density lipoprotein cholesterol (LDLc),uric acid (UA),homocysteine (Hcy),fibrinogen (Fib)and Creactive protein (CRP)to further analyze the factors of depression in patients withPD.Results The rates of anxiety respectively were 60.0%,56.25%,6.25% in Han PD,Uygur PD andnormal group .The rate of depression respectively were 48%,57.5%,7.5% in those three groups.The total scores of GAD7 in Han PD,Uygur PD and normal group were respectively (11.16±5.89),(9.84±5.62)and (3.75±2.94).The total scores of PHQ9 were respectively (9.60±5.64),(8.55±5.65)and(3.50±1.99)where there were significant differences between Uygur PD,Han PD and normal controlgroup,however no significant difference between Uygur and Han PD.Correlation analysis showed that thetotal score of PHQ9 were positively correlated with HY scale and GAD7 scores (β=0.012 and 0.633,P<0.05),and negatively correlated with UA (beta=-0.299,P <0.05).Multiple regression analysisshowed that the total score of PHQ9 was associated with GAD7 scores and UA (β= 0.631and 0.012,P<0.05).Conclusion The rate of incidence of anxiety and depression and severity in patients with PD werehigher than that of the general population.There was no significant difference in incidence of anxiety anddepression in patients between Uygur and Han PD,the factors of the mental health status of depression inpatients with PD were GAD7 and UA.The heavier anxiety degree,the lower the level of UA,the morebeing prone to depression in patients with PD.