帕金森病淡漠及其相关因素研究  

The clinical features and correlative factors of apathy in patients with Parkinson's disese

作　　者：贺诗佳 王艺蓉 孙玲 程波 余巨明[1] 张树山[1] HE Shi-jia;WANG Yi-rong;SUN Ling;CHENG Bo;YU Ju-ming;ZHANG Shu-shan(Department of Neurology of Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Neurology of Chengdu Second People's Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]川北医学院附属医院神经内科,四川南充637000 [2]成都市第二人民医院神经内科,四川成都610000

出　　处：《阿尔茨海默病及相关病杂志》2021年第1期37-41,45,共6页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：四川省基层卫生事业发展研究中心项目(项目编号:SWFZ17-Z-13)。

摘　　要：目的:调查帕金森病(PD)患者运动症状和非运动症状的临床特征,研究PD淡漠的相关因素。方法:本横断面研究纳入川北医学院附属医院就诊的120例临床确诊的PD患者,采用Lille淡漠量表(LARS)和非运动症状量表(NMSS)分别评估淡漠和非运动症状(NMS)。结果:45例(37.5%)PD患者出现淡漠。PD伴淡漠患者蒙特利尔认知功能评估量表(MoCA)得分、额叶功能评定量表(FAB)得分明显低于PD不伴淡漠患者。PD伴淡漠患者左旋多巴等效剂量(LEDD)、左旋多巴比例、H-Y分级、统一PD评定量表第三部分(UPDRS III)总分、PD生活质量问卷(PDQ-39)得分及贝克抑郁问卷(BDI)得分明显高于PD不伴淡漠患者。PD伴淡漠患者注意/记忆亚项及条目注意力缺乏和近记忆下降、胃肠道症状亚项及条目便秘、泌尿系统症状亚项及条目尿频和夜尿增多和入睡困难、丧失兴趣、淡漠、高兴不起来等条目的发生率明显高于PD不伴淡漠患者。Logistic分析发现MoCA得分、BDI得分、泌尿系统症状与PD淡漠有关。结论:淡漠在PD常见,合并认知障碍、抑郁和泌尿系统症状的患者易发生淡漠。Objectives:To survey correlative factors of apathy through investigating clinical features of motor symptoms and non-motor symptoms(NMS)in Parkinson's disease(PD)patients.Methods:Our cross-sectional study included 120 clinical diagnosed PD patients from neurology department,Affiliated Hospital of North Sichuan Medical College.Apathy was evaluated using the Lille Apathy Rating Scale(LARS)and Non-Motor Symptom Scale(NMSS)were used to access NMS.Results:Apathy was observed in 37.5%of PD patients in our study.The Montreal Cognitive Assessment(MoCA)and the Frontal Assessment Battery(FAB)were significantly lower in PD patients with apathy.The levodopa equivalent daily dose(LEDD),proportion of treatment with levodopa,scores of the H-Y stage,the Unified Parkinson’s Disease Rating Scale part III(UPDRS III),the 39-item PD Questionnaire(PDQ-39)and the Beck Depression Inventory(BDI)were significantly higher in PD patients with apathy.The prevalence of attention/memory domain with items“concentration”and“recent memory loss”,gastrointestinal domain with item“constipation”,urinary domain with items“nocturia”and“frequency micturition”,and items“difficulty falling asleep”,“lost of interest”,“apathy”and“feeling sad”were significantly higher in PD patients with apathy.The logistic regression indicated that lower MoCA scores,higher BDI scores and presence of urinary domain symptoms in NMSS were associated with apathy in PD.Conclusions:Apathy was common in PD patients.PD patients with cognitive dysfunction,depression and urinary symptoms were prone to present with apathy.

关 键 词：帕金森病 淡漠 Lille淡漠量表 抑郁 认知障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学]