肌萎缩侧索硬化患者认知与行为功能的调查

Cognitive and behavioral function of amyotrophic lateral sclerosis patients

目的分析肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)患者的认知、行为功能状况及相关影响因素,为临床护士制定早期干预措施提供依据。方法选取2021年7月至2022年5月在福建医科大学附属第一医院神经内科门诊就诊或住院的ALS患者作为研究对象,采用统一的临床资料调查表、汉化版爱丁堡ALS认知和行为检查量表(Edinburgh cognitive and behavioural ALS screen,ECAS)实施调查。ALS患者认知能力和行为能力影响因素分析采用二分类logistic回归分析。结果共调查ALS患者73例,认知能力平均得分(85.70±26.88)分,认知正常46例(63.01%),认知异常27例(36.99%),单因素分析结果显示,认知功能异常在不同受教育程度、发病年龄、病程患者中差异有统计学意义(P<0.05),在不同性别、发病部位患者中认知异常发生率差异无统计学意义(P>0.05)。多因素分析结果显示,受教育程度和病程是认知能力的独立影响因素(P<0.05)。行为能力中位得分为0(0,1)分,行为正常45例(61.64%),行为异常28例(38.36%),单因素分析结果显示,行为异常在不同病程患者中发生率的差异有统计学意义(P<0.05),行为异常在不同性别、受教育程度、发病年龄、发病部位患者中发生率的差异无统计学意义(P>0.05)。多因素分析结果显示,病程是行为能力的独立影响因素(P<0.05)。结论ALS患者认知和行为功能异常发生率较高,ALS患者的认知异常与受教育程度、病程有关,行为异常与病程有关,故应重视对疾病的早期发现,采取早期干预,以减轻患者的认知行为损害程度。

Objective To analyze the cognitive and behavioral function of amyotrophic lateral sclerosis(ALS)patients and related influencing factors,so as to provide a basis for clinical nurses to formulate early intervention measures.Methods ALS who visited or were hospitalized in the Department of Neurology at the First Affiliated Hospital of Fujian Medical University from July 2021 to May 2022 were selected.A baseline information collection table and the Edinburgh Cognitive and Behavioural ALS Screen were used to carry out the investigation.Results A total of 73 ALS patients were investigated in this study.The average cognitive score was 85.70±26.88;46 cases(63.01%)were cognitive-normal and 27 cases(36.99%)were cognitiveabnormal.Univariate analysis showed that there were statistically significant differences in cognitive abnormalities as a function of the education level,age of onset,and course of illness(P<0.05).There were no statistically significant differences in cognitive abnormalities based on gender and onset site(P>0.05).Multivariate logistic regression analysis indicated that education level and course of illness were independent influencing factors of cognitive ability(P<0.05).The behavioral score was 0(0,1);45 cases(61.64%)had normal behavior and 28 cases(38.36%)had abnormal behavior.Univariate analysis showed that there were statistically significant differences in behavioral abnormalities based on the course of illness(P<0.05),but there were no statistically significant differences in behavioral abnormalities based on gender,education level,age of onset,and site of onset(P>0.05).Multivariate logistic regression analysis indicated that the course of illness was an independent influencing factor of behavioral ability(P<0.05).Conclusions Most ALS patients have cognitive impairment,and the cognitive abnormalities of ALS patients are related to education level and course of illness,while the behavioral abnormalities are related to course of illness.Therefore,attention should be paid to the early detection of the disease and early intervention should be implemented to reduce the degree of cognitive and behavioral impairment.