帕金森病合并抑郁的影响因素及脑部葡萄糖代谢的改变  

Influencing factors of Parkinson’s disease complicated with depression and the changes of glucose metabolism in brain

作　　者：许保磊[1] 章晓君 孙炎 苏丹 梅珊珊[1] 孙虹[1] 刘疏影[1] 徐希彤 王慧[1] 毛薇[1] 许二赫[1] XU Bao-lei;ZHANG Xiao-jun;SUN Yan(Department of Neurology,Xuanwu Hospital of Capital Medical University,National Clinical Research Center for Geriatric Disorders,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,国家老年疾病临床医学研究中心,北京100053 [2]北京市化工职业病防治院 [3]河北北方学院附属第一医院 [4]北京市房山区良乡医院老年医学科

出　　处：《临床神经病学杂志》2022年第5期324-328,共5页Journal of Clinical Neurology

基　　金：国家重点研发计划“常见多发病防治研究”重点专项(2021YFC2501200)。

摘　　要：目的探讨帕金森病(PD)合并抑郁的影响因素及脑部葡萄糖代谢的改变。方法收集散发性PD患者63例,按照是否合并抑郁分组。采集并比较两组间一般临床资料及日常生活质量的差异,采用Logistic回归分析进行相关因素分析。采用头颅F-氟脱氧葡萄糖-PET(FDG-PET)检测两组脑部葡萄糖代谢的改变并比较。结果PD合并抑郁的患者(PD合并抑郁组)26例(41.27%),未合并抑郁的患者(PD组)37例。PD合并抑郁组患者尿酸水平明显高于PD组(P<0.05)。PD合并抑郁组患者39项PD生活质量问卷(PDQ39)评分明显高于PD组(P<0.05)。Logistic回归分析显示,尿酸水平(OR=1.003,95%CI:1.003~1.024,P=0.013)和PDQ39(OR=1.165,95%CI:1.042~1.303,P=0.007)是PD合并抑郁的独立影响因素。尿酸水平与PDQ39的ROC曲线下面积分别为0.659、0.724,二者联合的曲线下面积是0.763。PD合并抑郁组左颞叶及右颞叶葡萄糖代谢下降例数显著高于PD组(均P<0.05)。结论尿酸水平及PDQ39评分是PD合并抑郁的独立影响因素,对PD合并抑郁可能具有一定预测价值。颞叶葡萄糖代谢水平下降和PD合并抑郁相关,可能作为PD合并抑郁的影像标志物之一。Objective To investigated the influencing factors of Parkinson’s disease(PD)complicated with depression and the changes of glucose metabolism in brain.Methods Sixty-three sporadic PD patients were collected and divided into two groups according to whether with depression or not.The general clinical data and quality of daily life between the two groups were observed and compared.Logistic regression analysis was used to analyze the related factors.BrainF-Fludeoxyglucose-PET(FDG-PET)was used to detect the glucose metabolism,and the changes were compared between the two groups.Results There were 26 PD patients with depression(41.27%)(PD with depression group)and 37 PD patients without depression(PD group).The level of uric acid in PD with depression group was significantly higher than that in PD group(P<0.05).The 39 items PD quality of life questionnaire(PDQ39)score in PD with depression group was significantly higher than that in PD group(P<0.05).Logistic regression analysis showed that uric acid level(OR=1.003,95%CI:1.003-1.024,P=0.013)and PDQ39(OR=1.165,95%CI:1.042-1.303,P=0.007)were independent influencing factors of PD with depression.The area under ROC curve of uric acid level and PDQ39 were 0.659 and 0.724,respectively.And the area under the ROC curve of combined uric acid level and PDQ39 was 0.763.The decrease of glucose metabolism in left temporal lobe and right temporal lobe in PD with depression group were significantly higher than those in PD group(all P<0.05).Conclusions PDQ39 score and uric acid level are the independent influencing factors of PD complicated with depression,and have certain predictive value for PD complicated with depression.The decrease of glucose metabolism in temporal lobe is related to PD with depression,which may be an imaging marker of PD with depression.

关 键 词：帕金森病 抑郁 脑部葡萄糖代谢 

分 类 号：R742.5[医药卫生—神经病学与精神病学]