摘要：

目的 探讨焦虑和抑郁情绪对轻中度帕金森病患者认知功能的影响。方法 71 例原发性帕金森病患者，采用统一帕金森病评价量表（UPDRS）和Hoehn?Yahr 分级评价病情严重程度、汉密尔顿焦虑量表（HAMA，14 项）和汉密尔顿抑郁量表（HAMD，24 项）评价焦虑和抑郁情绪、简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA，北京版）评价认知功能，分析焦虑和抑郁情绪对认知功能的影响。结果 71 例患者均为轻中度帕金森病患者，出现焦虑61 例（85.92%）、抑郁55 例（77.46%）、同时出现焦虑和抑郁52 例（73.24%）。伴焦虑和抑郁患者UPDRS 评分分别高于无焦虑（P = 0.016）和无抑郁（P = 0.000）患者，伴焦虑患者MoCA 评分低于无焦虑患者（P = 0.042）。71 例患者中49 例（69.01%）出现认知功能障碍，其中轻度认知损害28 例（39.44%）、痴呆21 例（29.58%）。Logistic回归分析显示，仅焦虑是帕金森病患者认知功能障碍的独立危险影响（OR = 10.816，95%CI：1.682 ~ 69.560；P = 0.012）。结论 伴焦虑或抑郁情绪的帕金森病患者病情更严重，存在焦虑的帕金森病患者认知功能障碍患病率更高、程度更严重。

关键词: 帕金森病, 焦虑, 抑郁, 认知障碍, 回归分析

Abstract:

Objective  To explore the effect of anxiety and depression on cognitive function in patients with mild to moderate Parkinson's disease (PD).  Methods  A total of 71 patients with primary PD were enrolled in this study. Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr stage were used to evaluate the severity of the disease. Hamilton Anxiety Rating Scale (14-item version, HAMA-14) and Hamilton Depression Rating Scale (24-item version, HAMD-24) were used to evaluate the anxiety and depression. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA, Beijing version) were used to evaluate the cognitive function. The impact of anxiety and depression on cognitive function was analyzed.  Results  All of these patients were diagnosed as mild to moderate PD, including
61 patients (85.92% ) with anxiety, 55 patients (77.46% ) with depression and 52 patients (73.24% ) with concurrent anxiety and depression. The UPDRS score of patients with anxiety and depression were significantly higher than that of patients without anxiety (P = 0.016) or depression (P = 0.000). The MoCA score of PD patients with anxiety were significantly lower than that of patients without anxiety (P = 0.042). Among 71 patients, there were 49 cases (69.01% ) with cognitive dysfunction, including 28 patients (39.44% ) with mild cognitive impairment (MCI) and 21 cases (29.58% ) with dementia. There was no statistical difference of HAMA-14 and HAMD-24 scores among PD patients with different cognitive levels (P > 0.05, for all). Logistic regression analysis showed only anxiety was the independent risk factor for cognitive dysfunction of PD patients (OR = 10.816, 95%CI: 1.682-69.560; P = 0.012). Conclusions  The illness of PD patients accompanied by anxiety or depression is more serious. PD patients with anxiety have higher prevalence of cognitive dysfunction.

Key words: Parkinson disease, Anxiety, Depression, Cognition disorders, Regression analysis