浙江中西医结合杂志
浙江中西醫結閤雜誌
절강중서의결합잡지
ZHEJIANG JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE
2013年
11期
879-882
,共4页
钱铭净%顾群%姚林华%张玲
錢銘淨%顧群%姚林華%張玲
전명정%고군%요림화%장령
帕金森病%轻度认知障碍%发病率%蒙特利尔认知评估量表
帕金森病%輕度認知障礙%髮病率%矇特利爾認知評估量錶
파금삼병%경도인지장애%발병솔%몽특리이인지평고량표
Parkinson's disease%mild cognitive impairment%frequency%Montreal cognitive assessment
目的：调查帕金森病（PD）患者轻度认知损害的发生率，分析帕金森病伴有轻度认知损害（MCI，即PD-MCI）的特点及影响因素。方法：应用根据年龄及教育程度调整的MMSE量表分界值筛选出整体认知功能正常的非痴呆PD患者112例，应用蒙特利尔认知评估（MoCA）量表评价认知功能，MoCA评分逸26分者入PD认知正常组（PD-NC组），约26分者入PD轻度认知损害组（PD-MCI组），统计分析PD-MCI的发生率及其相关影响因素。同时选取55岁以上无明显躯体疾病的体检者115名作为对照组，MoCA评分后分为对照认知正常组（C-NC组）及对照轻度认知损害组（C-MCI组），比较PD-MCI组与C-MCI组MoCA各因素评分的差异及认知功能改变的特点。结果：PD组MCI发生率为55.4豫（62/112），对照组MCI发生率为27.8豫（32/115），差异有统计学意义（字2=17.73， P<0.05）。PD-MCI组MoCA视空间和执行、注意力、定向分测验得分均低于C-MCI组，差异有统计学意义（P<0.05）。单因素及Logistic回归分析显示统一帕金森评分量表芋得分越高，H-Y分级越大， HAMD分值越高则PD-MCI的发生率越高。结论：轻度认知损害在PD患者中较常见，主要表现为视空间和执行、注意力、定向等方面减退，且与运动障碍严重程度、抑郁相关。
目的：調查帕金森病（PD）患者輕度認知損害的髮生率，分析帕金森病伴有輕度認知損害（MCI，即PD-MCI）的特點及影響因素。方法：應用根據年齡及教育程度調整的MMSE量錶分界值篩選齣整體認知功能正常的非癡呆PD患者112例，應用矇特利爾認知評估（MoCA）量錶評價認知功能，MoCA評分逸26分者入PD認知正常組（PD-NC組），約26分者入PD輕度認知損害組（PD-MCI組），統計分析PD-MCI的髮生率及其相關影響因素。同時選取55歲以上無明顯軀體疾病的體檢者115名作為對照組，MoCA評分後分為對照認知正常組（C-NC組）及對照輕度認知損害組（C-MCI組），比較PD-MCI組與C-MCI組MoCA各因素評分的差異及認知功能改變的特點。結果：PD組MCI髮生率為55.4豫（62/112），對照組MCI髮生率為27.8豫（32/115），差異有統計學意義（字2=17.73， P<0.05）。PD-MCI組MoCA視空間和執行、註意力、定嚮分測驗得分均低于C-MCI組，差異有統計學意義（P<0.05）。單因素及Logistic迴歸分析顯示統一帕金森評分量錶芋得分越高，H-Y分級越大， HAMD分值越高則PD-MCI的髮生率越高。結論：輕度認知損害在PD患者中較常見，主要錶現為視空間和執行、註意力、定嚮等方麵減退，且與運動障礙嚴重程度、抑鬱相關。
목적：조사파금삼병（PD）환자경도인지손해적발생솔，분석파금삼병반유경도인지손해（MCI，즉PD-MCI）적특점급영향인소。방법：응용근거년령급교육정도조정적MMSE량표분계치사선출정체인지공능정상적비치태PD환자112례，응용몽특리이인지평고（MoCA）량표평개인지공능，MoCA평분일26분자입PD인지정상조（PD-NC조），약26분자입PD경도인지손해조（PD-MCI조），통계분석PD-MCI적발생솔급기상관영향인소。동시선취55세이상무명현구체질병적체검자115명작위대조조，MoCA평분후분위대조인지정상조（C-NC조）급대조경도인지손해조（C-MCI조），비교PD-MCI조여C-MCI조MoCA각인소평분적차이급인지공능개변적특점。결과：PD조MCI발생솔위55.4예（62/112），대조조MCI발생솔위27.8예（32/115），차이유통계학의의（자2=17.73， P<0.05）。PD-MCI조MoCA시공간화집행、주의력、정향분측험득분균저우C-MCI조，차이유통계학의의（P<0.05）。단인소급Logistic회귀분석현시통일파금삼평분량표우득분월고，H-Y분급월대， HAMD분치월고칙PD-MCI적발생솔월고。결론：경도인지손해재PD환자중교상견，주요표현위시공간화집행、주의력、정향등방면감퇴，차여운동장애엄중정도、억욱상관。
Objective:To investigate the frequency of mild cognitive impairment in patients with Parkinson's disease (PD) and healthy controls over 55 years of age without dementia and to analyze the characteristics and influencing factors of PD with mild cognitive impairment. Methods:One hundred and twelve PD patients having a normal age and education adjusted MMSE score were included in the further study of MoCA testing. Patients with MoCA score no less than 26 were selected into normal control PD-NC group,and patients with MoCA score less than 26 into mild cognitive impaired PD-MCI group. The frequency and influencing factors of PD-MCI were statistically ana-lyzed. One hundred and fifteen healthy subjects over the age of 55 without dementia were selected as control group,which divided into normal control C-NC group and mild cognitive impaired C-MCI group by MoCA testing. Scores of MoCA subtests were used in PD-MCI group and C-MCI group to compare the difference and characterize of cognitive changes. Results:The incidence of MCI in PD-MCI group was 55.4%(62/112) and 27.8%(32/115) in C-MCI group,with a significant difference between these 2 groups (x2=17.73,P<0.05). PD-MCI patients had lower scores in subtests of MoCA in visuospatia1, executive,attention and orientation compared with C-MCI patients (P<0.05). Univariate and logistic regression analysis revealed that a high frequency of PD-MCI occurred in patients with high UPDRS Ⅲ score,H-Y stage,and HAMD score. Conclusion:MCI is common in patients with PD,and the main cognitive deficits involve visuospatial,executive,attention, and orientation,which is associated with severity of motor disturbances and depression.
