重症肌无力患者汉密尔顿抑郁量表评分分析Analysis of scores of Hamilton depression rating scale in patients with myasthenia gravis
马姗;范玲玲;杨永祥;闫忠军;张慜;王钧刚;王圣元;李川;郭鹏;赵代弟;李柱一;
摘要(Abstract):
目的探讨重症肌无力(myasthenia gravis,MG)患者汉密尔顿抑郁量表(Hamilton depression rating scale,HDRS)评分情况及其影响因素分析。方法横断面研究2013-07—2015-03作者医院就诊的188例MG患者的临床资料和HDRS评分情况,并根据HDRS评分将其分为抑郁组和非抑郁组,分析两组MG患者的临床特点及其与HDRS评分间的关系。结果所纳入MG患者男女比例为1.02∶1,眼肌型重症肌无力(ocular myasthenia gravis,OMG)和全身型重症肌无力(generalized myasthenia gravis,GMG)的比例为1.2∶1,以OMG起病和以GMG起病患者的比例为6.2∶1,病程中位数为2年,四分位数间距为1.8年,平均量化重症肌无力评分(quantitative myasthenia gravis,QMG)为(6.7±2.3)分,平均HDRS评分为(8.7±3.4)分,并发抑郁者65例,未并发抑郁者123例。影响HDRS评分和抑郁发生的相关因素包括性别(P<0.01)、MG类型(P<0.01)、QMG得分(P<0.01)和美国重症肌无力协会(myasthenia gravis foundation of America,MGFA)分型(P<0.01)、有无甲状腺功能亢进(P<0.05)。结论影响MG患者HDRS评分和抑郁发生的相关因素包括性别、MG类型、QMG评分和MGFA分型、有无甲状腺功能亢进,充分认识其抑郁发生情况有利于更好地治疗MG。
关键词(KeyWords): 重症肌无力;抑郁;汉密尔顿抑郁评分量表;危险因素
基金项目(Foundation):
作者(Author): 马姗;范玲玲;杨永祥;闫忠军;张慜;王钧刚;王圣元;李川;郭鹏;赵代弟;李柱一;
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参考文献(References):
- [1]Conti-Fine BM,Milani M,Kaminski HJ.Myasthenia gravis:past,present,and future[J].J Clin Invest,2006,116(11):2843-2854.
- [2]Keesey JC.Does myasthenia gravis affect the brain?[J].J Neurol Sci,1999,170(2):77-89.
- [3]Kulaksizoglu IB.Mood and anxiety disorders in patients with myasthenia gravis:aetiology,diagnosis and treatment[J].CNS Drugs,2007,21(6):473-81.
- [4]Khler W.Psychosocial aspects in patients with myasthenia gravis[J].J Neurol,2007,254(Suppl 2):90-92.
- [5]Paradis CM,Friedman S,Lazar RM,et al.Anxiety disorders in a neuromuscular clinic[J].Am J Psychiatry,1993,150(7):1102-1104.
- [6]Hamilton M.A rating scale for depression[J].J Neurol Neurosurg Psychiatry,1960,23:56-62.
- [7]Jaretzki A,Barohn RJ,Ernstoff RM,et al.Myasthenia gravis:recommendations for clinical research standards,Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America[J].Neurology,2000,55(1):16-23.
- [8]Barohn RJ,McIntire D,Herbelin L,et al.Reliability testing of the quantitative myasthenia gravis score[J].Ann N Y Acad Sci,1998,841:769-772.
- [9]Grob D,Brunner N,Namba T,et al.Lifetime course of myasthenia gravis[J].Muscle Nerve,2008,37(2):141-149.
- [10]Marino M,Ricciardi R,Pinchera A,et al.Mild clinical expression of myasthenia gravis associated with autoimmune thyroid disease[J].J Clin Endocrinol Metab,1997,82(2):438-443.