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目的:调查分析广州地区帕金森病(Parkinson’s disease,PD)患者认知功能障碍的临床特点及其影响因素。方法:对广州地区六家医院107例PD患者进行问卷调查,采用蒙特利尔认知评估量表(MoCA)进行认知测评,并进行帕金森病统一评分量表(UPDRS)、汉密尔顿抑郁量表(HRSD)评分及Hoehn-Yahr(H-Y)分级评估,采用Spearman相关分析探讨影响认知功能的相关因素。结果:有83.2%的PD患者存在认知功能障碍,其中以短时记忆、语言功能最易受损,其次为视空间/执行能力、注意力、抽象思维,发生率均超过50%;PD患者MoCA评分与患者受教育年限呈正相关(r_s=0.542,P<0.05),与年龄、发病年龄、UPDRSⅡ-Ⅳ评分、H-Y分级及HRSD评分呈负相关(r_s分别为-0.257,-0.266,-0.472,-0.381,-0.357,均P<0.05),与病程、起病方式无关,服用与未服用多巴胺受体激动剂的PD患者间MoCA评分有显著差异(P<0.05)。结论:广州地区PD患者认知功能障碍的发生率较高,以短时记忆、语言最易受损;高龄、高发病年龄、运动障碍严重、抑郁状态的PD患者认知功能易受影响。
Objective: To investigate the clinical characteristics and the influencing factors of cognitive dysfunction in patients with Parkinson’s disease (PD) in Guangzhou. Methods: A total of 107 patients with PD in six hospitals in Guangzhou area were surveyed. The Montreal Cognitive Assessment Scale (MoCA) was used for cognitive assessment. UPDRS, Hamilton Depression Rating Scale (HRSD) ) Scores and Hoehn-Yahr (HY) grading assessment, using Spearman correlation analysis to explore the impact of cognitive function related factors. Results: There were 83.2% of patients with PD who had cognitive dysfunction. Among them, short-term memory was the most impaired in speech function, followed by visual space / executive ability, attention and abstraction. The incidence of PD was more than 50% There was a positive correlation between MoCA score and years of education (r_s = 0.542, P <0.05), and negatively correlated with age, age of onset, UPDRS Ⅱ-Ⅳ, HY and HRSD (r_s = -0.257, -0.266, -0.472 , -0.381, -0.357, all P <0.05). There was a significant difference (P <0.05) between MoCA scores in patients with and without dopamine agonist in patients with PD. Conclusion: The incidence of cognitive impairment in PD patients in Guangzhou is high, with short-term memory and language most vulnerable. The cognitive function of PD patients with advanced age, high incidence of age, dyskinesia, and depression is susceptible.