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目的探讨双侧丘脑底核脑深部电刺激(STN-DBS)对帕金森病人焦虑状况的影响。方法设置双侧STN-DBS组及左旋多巴类药物治疗组,配对入组,每组有效病例各31例。采用汉密尔顿焦虑量表(HAMA)、焦虑状态-特质问卷(STAI)、帕金森病生活质量39问卷(PDQ-39)及统一帕金森病评定量表第Ⅲ部分(UPDRS-Ⅲ)对病人进行评估分析。结果与术前及药物治疗组相比,STN-DBS组术后状态焦虑(S-AI)评分明显降低(均P<0.05)。STN-DBS组UPDRS-Ⅲ评分与S-AI评分在术后4个月内相关(均P<0.05),电压、脉宽与特质焦虑(T-AI)和HAMA评分均相关(均P<0.05);术后电压和脉宽对T-AI和HAMA评分的标准回归方程成立,回归系数均显著(均P<0.05)。结论 STN-DBS在改善帕金森病人运动障碍的同时,在短期内可改善即时焦虑情绪。在治疗范围内,STN-DBS电压和脉宽越高,帕金森病人的特质焦虑情绪和焦虑症状越严重。
Objective To investigate the effect of bilateral deep subthalamic nucleus electric stimulation (STN-DBS) on anxiety in Parkinson’s disease patients. Methods The bilateral STN-DBS group and levodopa drug treatment group were set up and matched into each group, with 31 cases in each group. Patients were assessed using the Hamilton Anxiety Scale (HAMA), the Anxiety-Status Questionnaire (STAI), the Parkinson’s Disease Quality of Life Questionnaire 39 (PDQ-39) and the Uniform Parkinson’s Disease Rating Scale Part III (UPDRS-III) analysis. Results Compared with preoperative and drug treatment groups, the state anxiety (S-AI) score of STN-DBS group was significantly lower (all P <0.05). The UPDRS-Ⅲ score of STN-DBS group was correlated with S-AI scores within 4 months after operation (all P <0.05), and the correlation between voltage and pulse width and trait anxiety (T-AI) and HAMA scores ). The standard regression equations of voltage and pulse width for T-AI and HAMA scores were established with significant regression coefficients (all P <0.05). Conclusions STN-DBS can improve immediate anxiety in the short term while improving dyskinesia in Parkinson’s disease patients. Within the treatment range, the higher the voltage and pulse width of STN-DBS, the more serious trait anxiety and anxiety symptoms in Parkinson’s patients.