本文選題：帕金森病　切入點(diǎn)：精神病性障礙　出處：《重慶醫(yī)學(xué)》2014年17期

【摘要】：目的評(píng)估帕金森病(PD)患者入院時(shí)以及隨訪12個(gè)月伴發(fā)精神病性障礙的患病率,并且分析與之相關(guān)的臨床因素。方法采用問(wèn)卷評(píng)估160例PD患者入院時(shí)以及隨訪12個(gè)月的神經(jīng)病學(xué)、精神病性癥狀、認(rèn)知功能,比較PD伴發(fā)精神病性障礙(PDPsy)與不伴發(fā)精神病性障礙(Non-PDPsy)患者的臨床特征,以及臨床特征與PDPsy的相關(guān)性。結(jié)果 (1)PDPsy入院時(shí)的患病率是12.5%,隨訪12個(gè)月后的發(fā)生率是21.3%,主要以幻覺(jué)與妄想為主。(2)入院時(shí),PDPsy患者與Non-PDPsy患者在病程(t=2.173,P=0.031)、日間睡眠障礙(t=2.076,P=0.040)、多巴替代治療劑量(t=2.820,P=0.005)上存在差異,PDPsy患者的病程更長(zhǎng)(5.6±2.3 vs.4.7±2.1)、日間思睡的發(fā)生率更高(6.9±2.4 vs.6.0±2.2)、左旋多巴胺劑量更大(610.2±246.6vs.490.1±212.9)。(3)隨訪12個(gè)月,PDPsy患者的UPDRS-Ⅲ評(píng)分[(29.7±9.7)分]、Hoehn-Yahr分級(jí)(≤2級(jí)占64.7%,2級(jí)占35.3%)、日間思睡評(píng)分[(7.2±2.4)分]、RBD發(fā)生率(41.2%)、HAMD評(píng)分[(17.3±7.4)分]、HAMA評(píng)分[(15.5±6.7)分]及多巴替代治療劑量[(670.8±251.1)mg]顯著高于Non-PDPsy患者[(26.6±7.1)分、≤2級(jí)占90.5%,2級(jí)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評(píng)分[(26.9±2.7)分]顯著低于Non-PDPsy[(28.7±3.1)分]。(4)病程、Hoehn-Yahr分級(jí)、HAMD得分、HAMA得分、ESS得分、RBD發(fā)生率均與PDPsy顯著相關(guān)。結(jié)論精神病癥狀可能出現(xiàn)在PD早期,在多巴替代治療時(shí),與PD有關(guān)的因素有疾病嚴(yán)重程度、認(rèn)知功能下降和抑郁癥狀,這可能是PD精神病性癥狀的潛在基礎(chǔ)。病程、Hoehn-Yahr分級(jí)、抑郁/焦慮、睡眠障礙是PDPsy的危險(xiǎn)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 鹵2.3 vs.4.7 鹵2.1), the incidence of daytime sleep was higher (6.9 鹵2.4 vs.6.0 鹵2.2), the dose of levodopamine was larger (610.2 鹵246.6vs.490.1 鹵212.9.3), and the UPDRS- 鈪，

本文編號(hào)：1672096