CAJ | 학술논문

目的分析非痴呆帕金森病(PD)患者认知功能的特点及其影响因素,为早期诊断和干预PD认知功能损害提供依据. 方法选择广州军区广州总医院神经内科自2010年1月至201 1年10月收治的PD患者56例,采用简易精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)评定其认知功能,Logistic逐步回归分析PD患者认知功能损害的影响因素. 结果以MMSE为评估标准时,6例(7.14％)PD患者存在轻度认知功能损害(MCI)；而以MoCA为标准时,40例(71.43％)PD患者存在MCI.MMSE和MoCA评分均与患者文化程度呈正相关关系(r=0.483,P=0.007；r=0.503,P=0.000).MMSE各认知域中评分下降幅度较大的是视空间、计算及注意力、复述和延迟记忆.认知域评分低于相应认知域总分患者例数较多的为延迟记忆、视空间、即刻记忆和复述.MoCA各认知域评分下降幅度较大的为复述、延迟记忆、抽象、视空间与执行;认知域评分低于相应认知域总分患者例数较多的为延迟记忆、复述、注意和视空间与执行.Logistic逐步回归分析显示文化程度和临床分型是影响PD认知功能损害的主要因素,即文化程度较低,少动强直型和混合型的PD患者认知功能损害风险增高. 结论认知功能损害在PD患者中常见,以延迟记忆、视空间与执行、计算及注意力、抽象和复述等认知域为主.文化程度和临床分型是PD认知功能损害的主要影响因素.
목적 분석비치태파금삼병(PD)환자인지공능적특점급기영향인소,위조기진단화간예PD인지공능손해제공의거. 방법 선택엄주군구엄주총의원신경내과자2010년1월지201 1년10월수치적PD환자56례,채용간역정신상태량표(MMSE)화몽특리이인지평고량표(MoCA)평정기인지공능,Logistic축보회귀분석PD환자인지공능손해적영향인소. 결과 이MMSE위평고표준시,6례(7.14％)PD환자존재경도인지공능손해(MCI)；이이MoCA위표준시,40례(71.43％)PD환자존재MCI.MMSE화MoCA평분균여환자문화정도정정상관관계(r=0.483,P=0.007；r=0.503,P=0.000).MMSE각인지역중평분하강폭도교대적시시공간、계산급주의력、복술화연지기억.인지역평분저우상응인지역총분환자례수교다적위연지기억、시공간、즉각기억화복술.MoCA각인지역평분하강폭도교대적위복술、연지기억、추상、시공간여집행;인지역평분저우상응인지역총분환자례수교다적위연지기억、복술、주의화시공간여집행.Logistic축보회귀분석현시문화정도화림상분형시영향PD인지공능손해적주요인소,즉문화정도교저,소동강직형화혼합형적PD환자인지공능손해풍험증고. 결론 인지공능손해재PD환자중상견,이연지기억、시공간여집행、계산급주의력、추상화복술등인지역위주.문화정도화림상분형시PD인지공능손해적주요영향인소.
Objective To analyze the characteristics of cognitive function impairment in PD patients without dementia and their influencing factors, and provide evidence for early recognition and treatment of cognitive deficits in PD patients. Methods Fifty-six PD patients without dementia,admitted to our hospital from January 2010 to October 2011 were assessed with mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) for cognitive function. Logistic stepwise regression was employed to analyze the influencing factors of cognitive function impairment.Results Using MMSE scores as the standard for recognition, PD patients with mild cognitive impairment (MCI) accounted for 7.14％ (6/56); however,using MoCA scores,they accounted for 71.43％(40/56). Both of the MMSE and MoCA scores were positively correlative with the education degree of the patients (r=0.483,P=-0.007; r=0.503,P=0.000).In the cognitive domain of MMSE,the scores of visuospatial function,and abilities of delayed recall,calculation,attention and repetition had significant decrement; and MMSE indicated that abilities of delayed recall, immediate memory, calculation and attention,and visuospatial function were main cognitive disturbances of PD.In the cognitive domain of MoCA,the scores of visuospatial and executive functions,and abilities of delayed recall,abstraction and repetition had significant decrement; MoCA indicated that visuospatial and executive functions,abilities of delayed recall,denomination,attention,abstraction and repetition were main cognitive disturbances of PD. Logistic regression analysis showed that education degree and clinical types were the main influencing factors of cognitive function impairment in PD patients. Conclusion Cognitive impairment is very common in patients with PD,and the main cognitive deficits involve visuospatial and executive functions,abilities of delayed recall,calculation,attention,abstraction and repetition; education degree and clinical types are the influencing factors of cognitive impairment of PD.