《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (02): 220-223.

• 临床研究 • 上一篇    下一篇

基于临床异质性的帕金森病患者抑郁分析

王雪梅1，冯涛1，顾朱勤2，刘萍3，陈彪2   

  1. 1.首都医科大学附属北京天坛医院神经病学中心神经变性病科，北京脑重大疾病研究院，北京市100050；2.首都医科大学宣武医院，北京市100053；3.浙江大学医学院附属第一医院神经内科，浙江杭州市310003。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-02-25 发布日期:2015-02-25

Condition of Depression Based on the Clinical Heterogeneity of Idiopathic Parkinson's Disease

WANG Xue- mei, FENG Tao, GU Zhu-qin, LIU Ping, CHEN Biao   

  1. Department of Neurodegenerative Disease, Centre of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, Beijng 100050, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-02-25 Online:2015-02-25

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被引次数

14

摘要： 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。

关键词: 帕金森病, 异质性, 抑郁, 聚类分析

Abstract: Objective The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Aim of this study is to assess the severity of depression in patients with PD of different clinical subtypes. Methods A broad spectrum of motor variables and nonmotor features, including tremor, rigidity, hypokinesia, postural instability gait disorder, fatigue, constipation, apathy, depression, global cognitive function, as well as the clinical data and demographics, including age, gender, age at disease onset, course of disease, were collected in 600 Chinese PD patients. The PD subtypes were classified using k-means (k=4) cluster analysis according to the clinical data. Their depression was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Results The cluster analysis indicated 4 main subtypes: Subtype 1 was mildly affected in all domains, and the ratio of tremor score to non-tremor score was the highest among the 4 clusters. Subtype 2 was severely in all motor and nonmotor symptoms. Subtype 3 showed intermediate severity in most domains. Subtype 4 was characterized by short course and rapid progression of disease. 43.5% of cases were identified as in depression. There was significant difference in scores of CES-D among the 4 subtypes (P<0.05). Conclusion Depression occurred frequently in patients with PD with some clinical heterogeneity.

Key words: Parkinson's disease, heterogeneity, depression, cluster analysis