论文部分内容阅读
目的帕金森病临床表现的异质性提示该病存在不同的临床亚型。本研究旨在评估不同临床亚型帕金森病患者的抑郁状况。方法基于帕金森病患者运动及非运动临床表现,包括震颤、强直、少动、姿势步态异常、疲劳、便秘、淡漠、抑郁、认知障碍等以及基本人口学及临床资料,如年龄、性别、发病年龄、病程等,采用4分类聚类分析对600例原发性帕金森病患者进行分型。应用流行病调查中心抑郁量表(CES-D)评估患者的抑郁状态。结果 600例原发性帕金森病患者共聚类为4个亚型。亚型1患者各种临床表现均轻,且以运动表型为主;亚型2患者各种运动及非运动症状均最重;亚型3患者的临床症状严重程度介于亚型1和2之间;亚型4以病程短、疾病进展速度快为特征。43.5%的帕金森病患者存在不同程度的抑郁。不同亚型间CES-D评分有显著性差异(P<0.05)。结论抑郁是帕金森病患者常见的非运动症状,抑郁状况存在临床异质性。
Purpose The heterogeneity of the clinical manifestations of Parkinson’s disease suggests that there are different clinical subtypes of the disease. The aim of this study was to assess the prevalence of depression in patients with different clinical subtypes of Parkinson’s disease. Methods Based on the clinical and non-motor clinical manifestations of Parkinson’s disease patients, including tremor, rigidity, motionlessness, gait abnormalities, fatigue, constipation, indifference, depression and cognitive impairment as well as basic demographic and clinical data such as age, , Age of onset, course of disease and so on. Four groups of cluster analysis were used to classify 600 patients with primary Parkinson’s disease. Depression was assessed using the Epidemiology Center Depression Rating Scale (CES-D). Results 600 patients with primary Parkinson’s disease co-clustered into four subtypes. Subtype 1 patients were all clinical manifestations were light, and the main motor phenotype; subtype 2 patients with the most all kinds of motor and non-motor symptoms were the most severe; subtype 3 patients with clinical symptoms ranging from subtype 1 and 2 ; Subtype 4 to short duration, the disease is characterized by rapid progress. 43.5% of patients with Parkinson’s disease have different degrees of depression. The CES-D scores of different subtypes were significantly different (P <0.05). Conclusions Depression is a common non-motor symptom in patients with Parkinson’s disease. Depression is clinically heterogeneous.