CAJ | 학술논문

目的探讨原发性震颤(essential tremor,ET)患者的认知功能和情绪障碍及其相互关系.方法采用简易智能量表(MMSE)、汉语失语症检查法口语表达分测验及阅读分测验、Rey复杂图形测验、修订韦氏成人智力量表中的数字广度分测验、相似性分测验、符号-数字分测验、威斯康星卡片分类测验、连线测验、词语流畅性测验和画钟测验,对40例ET患者和40名年龄、文化程度、利手等相匹配的健康对照进行认知评定.同时,采用汉密尔顿抑郁量表(HAMD)测评患者的抑郁情绪,HAMD 评分>8 分为伴有抑郁症状.结果 ET组的Rey复杂图形测验(t=6.66,P<0.001)、数字广度分测验(顺)(t=3.32,P<0.001)、符号-数字分测验(t=4.18,P<0.001)、威斯康星卡片分类测验各项(P<0.05)、连线测验(t=3.59,P<0.001)、词语流畅性测验(t=-3.98,P<0.001)和画钟测验(t=-4.18,P<0.001)等各项成绩均较正常对照组低;而在汉语失语症检查法口语表达分测验及阅读分测验、相似性测验中两组间得分差异无统计学意义(P>0.05);患者组各项认知测验成绩与震颤强度和病程无关(P>0.05);52.5%(21/40) ET患者合并抑郁症状,但多为轻度抑郁(71.4%);抑郁症状的发生与年龄有关(X~2=27.03,P<0.001),多出现在50岁以下的患者(85.7%);是否伴有抑郁的ET组之间各项认知测验得分差异无统计学意义(P>0.05).结论 ET患者存在多认知域的功能障碍,尤以执行功能、注意力及记忆受损较为明显;ET患者中抑郁症状的发生率较高.
목적 탐토원발성진전(essential tremor,ET)환자적인지공능화정서장애급기상호관계.방법 채용간역지능량표(MMSE)、한어실어증검사법구어표체분측험급열독분측험、Rey복잡도형측험、수정위씨성인지역량표중적수자엄도분측험、상사성분측험、부호-수자분측험、위사강성잡편분류측험、련선측험、사어류창성측험화화종측험,대40례ET환자화40명년령、문화정도、리수등상필배적건강대조진행인지평정.동시,채용한밀이돈억욱량표(HAMD)측평환자적억욱정서,HAMD 평분>8 분위반유억욱증상.결과 ET조적Rey복잡도형측험(t=6.66,P<0.001)、수자엄도분측험(순)(t=3.32,P<0.001)、부호-수자분측험(t=4.18,P<0.001)、위사강성잡편분류측험각항(P<0.05)、련선측험(t=3.59,P<0.001)、사어류창성측험(t=-3.98,P<0.001)화화종측험(t=-4.18,P<0.001)등각항성적균교정상대조조저;이재한어실어증검사법구어표체분측험급열독분측험、상사성측험중량조간득분차이무통계학의의(P>0.05);환자조각항인지측험성적여진전강도화병정무관(P>0.05);52.5%(21/40) ET환자합병억욱증상,단다위경도억욱(71.4%);억욱증상적발생여년령유관(X~2=27.03,P<0.001),다출현재50세이하적환자(85.7%);시부반유억욱적ET조지간각항인지측험득분차이무통계학의의(P>0.05).결론 ET환자존재다인지역적공능장애,우이집행공능、주의력급기억수손교위명현;ET환자중억욱증상적발생솔교고.
Objective To investigate the cognitive function and emotional disorder and their interrelationships in patients with essential tremor(ET).Methods The cognitive function was evaluated by using scales such as mini-mental state examination (MMSE), aphasia buttery of Chinese for oral-test and read-test, Rey-Osterreith complex figure (ROF), digit span (DS), similarties tests, symbols-digital test, Wisconsin card sorting test, trail making test A, verbal fluency test and clock drawing test in fourty cases and fourty healthy controls matched on age, education level and handedness.The Hamilton depression scale was applied to assess the emotional state of the patients with ET.Results Compared with healthy controls, patients had significantly lower scores in Rey-Osterreith complex figure (t=6.66,P<0.001),digit span (positive)(t=3.32,P<0.001),symbols-digital test (t=4.18,P<0.001),Wisconsin card sorting test (P<0.05),trail making test A (t=3.59,P<0.001),verbal fluency test (t=-3.98,P<0.001) and clock drawing test (t=-4.18,P<0.001), but similar scores in aphasia buttery of Chinese for oral-test and read-test and similarties tests(P>0.05).The cognitive function scores were not significantly associated with the intensity and duration of tremor in patients with ET(P>0.05).Depression, mostly mild depression, was observed in 52.5 percent of patients with ET.Depression was significantly associated with the age (X~2=27.03, P<0.001) and was observed more frequently in the patients under the age of 50.There was no significant association between the cognitive impairment and depression in patients with ET (P>0.05).Conclusions The patients with ET have a multiple-domain cognitive deficit, in which executive function, attention and memory are impaired more severely.The patients with ET have a high incidence of depressive symptoms.