多系统萎缩患者疲乏的患病率及其与抑郁的关系  

Prevalence of fatigue in patients with multiple system atrophy and its relationship with depression

作　　者：潘竞[1] 康佳 王新 海日罕 韩晓雨 陈彪 Pan Jing;Kang Jia;Wang Xin;Hai Rihan;Han Xiaoyu;Chen Biao(Department of Internal Medicine,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010020,China;Department of Neurobiology,Neurology and Geriatrics,Xuanwu Hospital of Capital Medical University,Beijing Institute of Geriatrics,Beijing 100053,China;Beijing Institute of Brain Disorders,Collaborative Innovation Center for Brain Disorders,Capital Medical University,Beijing 100053,China;National Clinical Research Center for Geriatric Disorders,Beijing 100053,China)

机构地区：[1]内蒙古医科大学第二附属医院内科中心,呼和浩特010020 [2]首都医科大学宣武医院,北京市老年病医疗研究中心,神经生物室/神经内科/老年医学,北京100053 [3]首都医科大学脑重大疾病研究中心,北京脑重大疾病研究院,脑重大疾病防治省部共建协同创新中心,北京100053 [4]国家老年疾病临床医学研究中心,北京100053

出　　处：《中华老年医学杂志》2024年第5期581-585,共5页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(No.2021YFC2501200、2018YFC1312001);内蒙古自然科学基金(2020MS08138);内蒙古自治区医疗卫生科技计划项目(202202216);内蒙古医科大学项目(YKD2022LH024)。

摘　　要：目的探讨多系统萎缩(MSA)患者疲乏的患病率及其与焦虑抑郁的关系。方法本研究为横断面研究,收集首都医科大学宣武医院的MSA住院患者44例,将疲乏严重程度量表(FSS)≥4分定义为存在疲乏,使用统一帕金森病评估量表(MDS-UPDRS)和统一多系统萎缩评估量表(UMSARS)对患者进行运动症状的评估,使用汉密尔顿抑郁量表(HAMD)、老年抑郁量表(GDS)和汉密尔顿焦虑量表(HAMA)评估患者焦虑抑郁情况。结果患者年龄为(60.1±6.4)岁,FSS的得分为(4.3±2.4)分,其中,有28例(63.6%)患者存在疲乏。与非疲乏组患者相比,疲乏组患者存在明显的焦虑(HAMA)分别为[(16.5±8.9)分和(9.4±5.0)分,t=-2.292,P=0.010]和抑郁(HAMD)分别为[(14.4±7.0)分和(8.4±3.4)分,t=6.192,P=0.017]与GDS分别为[(18.2±7.4)分和(10.7±5.2)分,t=-3.560,P=0.044]。MSA患者的疲乏严重程度与焦虑(HAMA,r=0.516,P<0.001)、抑郁(HAMD,r=0.551,P<0.001)以及GDS(r=0.636,P<0.001)和日常生活能力得分(r=0.320,P=0.034)呈正相关,与患者的运动症状和疾病的严重程度无关。结论近三分之二的MSA患者存在疲乏症状,疲乏与焦虑和抑郁水平显著相关,影响患者的情绪和日常生活。Objective Fatigue is one of the common disabling non-motor symptoms of multiple system atrophy(MSA).This study aimed to investigate the prevalence of fatigue in MSA patients and its relationship with anxiety and depression.Methods In this cross-sectional study,44 MSA inpatients from Xuanwu Hospital of Capital Medical University were enrolled.Fatigue was defined as a Fatigue Severity Scale(FSS)score≥4.The motor symptoms of the patients were evaluated using the Unified Parkinson's Disease Rating Scale(MDS-UPDRS)and Unified Multi-System Atrophy Rating Scale(UMSARS).The Hamilton Rating Scale for Depression(HAMD),Geriatric Depression Scale(GDS)and Hamilton Anxiety Scale(HAMA)were used to assess anxiety and depression.Results The mean age of the MSA patients was 60.1±6.4 years,and the score of FSS was 4.3±2.4,with 28 patients(63.6%)having fatigue.Compared with the non-fatigue group,the fatigue group showed clear anxiety(HAMA:16.5±8.9 vs.9.4±5.0,t=-2.292,P=0.010)and depression(HAMD:14.4±7.0 vs.8.4±3.4,t=6.192,P=0.017;GDS:18.2±7.4 vs.10.7±5.2,t=-3.560,P=0.044).The severity of fatigue in MSA patients was positively correlated with anxiety(r=0.516,P<0.001),depression(HAMD:r=0.551,P<0.001;GDS:r=0.636,P=0.000)and the score of activities of daily living(r=0.320,P=0.034),but not correlated with motor symptoms or disease severity.Conclusions Nearly two-thirds of MSA patients have symptoms of fatigue,and fatigue is significantly associated with levels of anxiety and depression,affecting patients'mood and activities of daily living.

关 键 词：多系统萎缩 疲乏 焦虑 抑郁 

分 类 号：R749.4[医药卫生—神经病学与精神病学]