帕金森病合并精神障碍的临床研究

目的：了解帕金森病（PD）合并精神障碍的发生率及临床特点，分析其影响因素和可能的原因。方法：选取300例确诊为帕金森病的门诊患者，采用UPDRS Ⅲ评定患者开期的运动功能，Hoehn-Yahr分级判定患者病情严重程度，采用阴性症状量表（SANS）和阳性症状量表（SAPS）评价患者精神症状的严重程度。结果：300例PD患者中，175例（58．3％）出现较为严重的阴性精神症状，其中缺乏社交兴趣171例（57．0％），情感平淡或迟钝164（54．6％），意志缺乏103（34．3％），经分析PD患者阴性精神症状与UPDRSⅢ评分、Hoehn—Yahr分级、年龄、左旋多巴每日剂量相关，与性别无关。18例（6．0％）出现较为严重的阳性精神症状，其中幻觉16例（5．3％），最常见于使用安坦（28．75％）的患者。结论：PD患者精神障碍较为常见，主要表现为缺乏社交兴趣、情感平淡或迟钝、意志缺乏、幻觉等，阴性精神症状与UPDRSm评分、Hoehn-Yahr分级、年龄、左旋多巴每日剂量相关，与性别无关。

The clinical study on mental disorders in Parkinson's disease

Objective: To observe the occurrence and the characteristic of mental disorders in Parkinson's disease,the clinical features and the impacting factors.Methods: 300 consecutive out-patients with PD were assessed by means of the Unified Parkinson's Disease Rating Scale Ⅲ(UPDRSⅢ) and were staged by the Hoehn and Yahr system(H/Y).The levels of mental disorders were assessed by Scale for the Assessment of Negative Symptoms(SANS) and Scale for Assessment of Positive Symptoms(SAPS).Results: Severe negative symptoms were seen in 175(58.3%) PD patients,including 171 patients(57.0%) lack of interest in public relations,164 patients(54.6%) with plain or clumsy emotion,103 patients(34.3%) with will lack.Using stepwise liner regression and partial correlation,we found negative symptoms were correlated with UPDRSⅢ,Hoehn-Yahr,age and the daily dosage of L-dopa,independent of gender.Severe positive symptoms were seen in 18(6.0%) PD patients.Illusions were the most common symptoms and often occurred in patients using Artane(28.75%).Conclusion: Mental disorders are common in Parkinson's disease,and the main symptoms include the lack of interest in public relations,plain or clumsy emotion,will lack and illusion.Negative symptoms were correlated with UPDRS,Hoehn-Yahr,age and the daily dosage of L-dopa,but were independent of gender.