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目的研究131例门诊帕金森病(Parkinson’s disease,PD)患者中亚抑郁的发病率及其临床特点。方法采用统一PD评定量表(Unified Parkinson’s Disease Rating Scale,UPDRS),Hoehn-Yahr(H&Y)分级和简易智力状态检查(Mini-Mental State Examimation,MMSE)对患者进行评估和分级,根据汉密顿抑郁量表(Hamilton Rating Scale for Depression,HRSD)得分情况将患者分为非抑郁组、亚抑郁组和抑郁组,研究亚抑郁与临床特征间关系及其症状特点。结果27例(20.6%)患者被纳入抑郁组,71例(54.2%)患者被纳入亚抑郁组,33例(25.2%)患者被纳入非抑郁组。年龄、性别和震颤评分在各组间无差异(P>0.05),亚抑郁组与抑郁组类似,在PD病程、UPDRS总分、强直评分和H&Y分级上与非抑郁组有明显差异(P<0.05),且这些指标的强度从亚抑郁到抑郁呈递增趋势。亚抑郁组的常见症状为兴趣缺失、能力减退感、睡眠障碍、胃肠道症状和抑郁情绪,但其同样为抑郁组和非抑郁组的常见症状。结论亚抑郁与抑郁一样是PD的一种常见并发症,与PD的各种特征有类似的联系,并可能伴随PD的进一步进展而发展为抑郁。由于PD伴随症状与亚抑郁症状之间的重叠性,进一步的研究需要针对这些症状来制订更为详尽的亚抑郁诊断评分标准。
Objective To study the incidence and clinical features of sub-depression in 131 outpatients with Parkinson’s disease (PD). Methods The patients were evaluated and classified according to the Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn-Yahr (H & Y) classification and Mini-Mental State Examimation (MMSE) Patients were divided into non-depression group, sub-depression group and depression group according to the scores of Hamilton Rating Scale for Depression (HRSD). The relationship between sub-depression and clinical features and their symptoms and signs were studied. Results Twenty-seven patients (20.6%) were included in the depression group, 71 (54.2%) were included in the sub-depression group and 33 (25.2%) were included in the non-depression group. There was no significant difference in age, gender and tremor score among the groups (P> 0.05). The sub-depression group was similar to the depression group, and there was a significant difference in PD course, UPDRS score, tonic score and H & 0.05), and the intensity of these indicators showed an increasing trend from sub-depression to depression. Common symptoms in sub-depressive groups were loss of interest, impaired ability to attend, sleep disorders, gastrointestinal symptoms, and depression, but they were also common symptoms in both depression and non-depression groups. Conclusions Like depression, depression is a common complication of PD. It has a similar relationship with various features of PD and may develop depression with the further development of PD. Due to the overlap between PD-associated symptoms and sub-depressive symptoms, further studies need to develop more detailed sub-depressive diagnostic criteria for these symptoms.