CAJ | 학술논문

目的：帕金森病临床表现的异质性提示该病存在不同的临床亚型。本研究旨在评估不同临床亚型帕金森病患者的抑郁状况。方法基于帕金森病患者运动及非运动临床表现，包括震颤、强直、少动、姿势步态异常、疲劳、便秘、淡漠、抑郁、认知障碍等以及基本人口学及临床资料，如年龄、性别、发病年龄、病程等，采用4分类聚类分析对600例原发性帕金森病患者进行分型。应用流行病调查中心抑郁量表(CES-D)评估患者的抑郁状态。结果600例原发性帕金森病患者共聚类为4个亚型。亚型1患者各种临床表现均轻，且以运动表型为主；亚型2患者各种运动及非运动症状均最重；亚型3患者的临床症状严重程度介于亚型1和2之间；亚型4以病程短、疾病进展速度快为特征。43.5%的帕金森病患者存在不同程度的抑郁。不同亚型间CES-D评分有显著性差异(P<0.05)。结论抑郁是帕金森病患者常见的非运动症状，抑郁状况存在临床异质性。
목적：파금삼병림상표현적이질성제시해병존재불동적림상아형。본연구지재평고불동림상아형파금삼병환자적억욱상황。방법기우파금삼병환자운동급비운동림상표현，포괄진전、강직、소동、자세보태이상、피로、편비、담막、억욱、인지장애등이급기본인구학급림상자료，여년령、성별、발병년령、병정등，채용4분류취류분석대600례원발성파금삼병환자진행분형。응용류행병조사중심억욱량표(CES-D)평고환자적억욱상태。결과600례원발성파금삼병환자공취류위4개아형。아형1환자각충림상표현균경，차이운동표형위주；아형2환자각충운동급비운동증상균최중；아형3환자적림상증상엄중정도개우아형1화2지간；아형4이병정단、질병진전속도쾌위특정。43.5%적파금삼병환자존재불동정도적억욱。불동아형간CES-D평분유현저성차이(P<0.05)。결론억욱시파금삼병환자상견적비운동증상，억욱상황존재림상이질성。
Objective The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Aim of this study is to assess the severity of depression in patients with PD of different clinical subtypes. Methods A broad spectrum of motor variables and non-motor features, including tremor, rigidity, hypokinesia, postural instability gait disorder, fatigue, constipation, apathy, depression, global cog-nitive function, as well as the clinical data and demographics, including age, gender, age at disease onset, course of disease, were collected in 600 Chinese PD patients. The PD subtypes were classified using k-means (k=4) cluster analysis according to the clinical data. Their de-pression was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Results The cluster analysis indicated 4 main sub-types:Subtype 1 was mildly affected in all domains, and the ratio of tremor score to non-tremor score was the highest among the 4 clusters. Subtype 2 was severely in all motor and nonmotor symptoms. Subtype 3 showed intermediate severity in most domains. Subtype 4 was char-acterized by short course and rapid progression of disease. 43.5%of cases were identified as in depression. There was significant difference in scores of CES-D among the 4 subtypes (P<0.05). Conclusion Depression occurred frequently in patients with PD with some clinical het-erogeneity.