住院帕金森病患者伴发精神病性障碍的临床特点及危险因素研究

发布时间：2018-03-27 15:24

  本文选题：帕金森病　切入点：精神病性障碍　出处：《重庆医学》2014年17期

【摘要】：目的评估帕金森病(PD)患者入院时以及随访12个月伴发精神病性障碍的患病率,并且分析与之相关的临床因素。方法采用问卷评估160例PD患者入院时以及随访12个月的神经病学、精神病性症状、认知功能,比较PD伴发精神病性障碍(PDPsy)与不伴发精神病性障碍(Non-PDPsy)患者的临床特征,以及临床特征与PDPsy的相关性。结果 (1)PDPsy入院时的患病率是12.5%,随访12个月后的发生率是21.3%,主要以幻觉与妄想为主。(2)入院时,PDPsy患者与Non-PDPsy患者在病程(t=2.173,P=0.031)、日间睡眠障碍(t=2.076,P=0.040)、多巴替代治疗剂量(t=2.820,P=0.005)上存在差异,PDPsy患者的病程更长(5.6±2.3 vs.4.7±2.1)、日间思睡的发生率更高(6.9±2.4 vs.6.0±2.2)、左旋多巴胺剂量更大(610.2±246.6vs.490.1±212.9)。(3)随访12个月,PDPsy患者的UPDRS-Ⅲ评分[(29.7±9.7)分]、Hoehn-Yahr分级(≤2级占64.7%,2级占35.3%)、日间思睡评分[(7.2±2.4)分]、RBD发生率(41.2%)、HAMD评分[(17.3±7.4)分]、HAMA评分[(15.5±6.7)分]及多巴替代治疗剂量[(670.8±251.1)mg]显著高于Non-PDPsy患者[(26.6±7.1)分、≤2级占90.5%,2级占9.5%、(7.2±2.4)分、19.8%、(13.2±7.2)分、(11.7±6.4)分、(520.1±221.4)mg]。而PDPsy患者的MMSE评分[(26.9±2.7)分]显著低于Non-PDPsy[(28.7±3.1)分]。(4)病程、Hoehn-Yahr分级、HAMD得分、HAMA得分、ESS得分、RBD发生率均与PDPsy显著相关。结论精神病症状可能出现在PD早期,在多巴替代治疗时,与PD有关的因素有疾病严重程度、认知功能下降和抑郁症状,这可能是PD精神病性症状的潜在基础。病程、Hoehn-Yahr分级、抑郁/焦虑、睡眠障碍是PDPsy的危险因子。
[Abstract]:Objective to evaluate the prevalence of psychiatric disorders at admission and 12 months follow-up in patients with Parkinson's disease (PD) and to analyze the clinical factors associated with them. Methods 160 patients with PD were assessed by questionnaire at admission and 12 months follow-up. To compare the clinical characteristics of patients with PD with and without psychiatric disorders (P < 0.05). Results the prevalence rate of PDPsy on admission was 12.5, and the incidence after 12 months follow-up was 21.3, mainly hallucination and delusion. There were significant differences in the dosages of dopa replacement therapy (DOPA 2.820g / P0. 005). The course of disease was longer (5.6 卤2.3 vs.4.7 卤2.1), the incidence of daytime sleep was higher (6.9 卤2.4 vs.6.0 卤2.2), the dose of levodopamine was larger (610.2 卤246.6vs.490.1 卤212.9.3), and the UPDRS- 鈪，

本文编号：1672096