多发性硬化患者认知损害的检测及其影响因素分析

The cognitive impairment in multiple sclerosis patients and its influencing factors

目的探讨多发性硬化患者认知功能损害情况及相关影响因素。方法选择我院2017年2月~2019年2月收治的多发性硬化患者50例做为观察组,同期收治健康体检者50例为对照组,对比两组头颅磁共振(MRI)和蒙特利尔认知评估量表(MoCA)检测结果,同时应用扩展功能障碍状态量表(EDSS)评估观察组神经缺损程度,分析认知损害特点及相关影响因素。结果观察组MoCA量表中,语言、延迟记忆、命名、视空间与执行、总分与对照组比较差异具有统计学意义(P<0.05);而定向、注意、抽象、计算与对照组比较无统计学差异(P>0.05);观察组患者MoCA量表测验显示,低于正常标准33例,占66%。MoCA异常患者分型、病程与正常患者存在差异(P<0.05),而在MRI病灶等级、EDSS评分、受教育年限方面二者无明显差异(P>0.05)。采用Pearson相关分析发现MoCA评估异常与患者分型和病程相关(P<0.05),而与MRI病灶等级、EDSS评分、受教育年限无明显相关(P>0.05)。EDSS与执行功能之间存在负性相关(P<0.05)。结论多发性硬化患者存在一些认知损害;认知损害程度与分型、病程相关。

Objective To investigate the cognitive impairment and related influencing factors in patients with multiple sclerosis.Methods Fifty patients with multiple sclerosis were enrolled as the observation group and 50 healthy subjects were enrolled as the control group.MRI and the Montreal Cognitive Assessment Scale(MoCA)test results,and the Extended Disorder Status Scale(EDSS)were used to assess the degree of neurological deficits,and the related influencing factors were analyzed.Results The total scores,and the scores of language,delayed memory,naming,visual space and execution in the observation group were lower than those in control group(P<0.05).33 cases of the observation group showed abnormal in MoCA scale test,accounting for 66%.There were differences between the patients with or without MoCA abnormality in the classification and duration of disease(P<0.05),but there was no significant difference in the MRI lesion grade,EDSS score and education years(P>0.05).The scores of MoCA was associated with the types and duration of disease(P<0.05).There was negative correlation between EDSS and executive function(P<0.05).Conclusion The multiple sclerosis patients do have some cognitive impairment;the degree of cognitive impairment is closely related to the classification and duration of the disease.