多发性硬化患者认知功能损害的特点

Characteristics of cognitive dysfunction in patients with multiple sclerosis

目的:探讨多发性硬化患者认知功能损害的特点、相关影响因素及认知功能损害对患者生活功能的影响。资料来源:应用计算机检索Medline2000-01/2004-12与多发性硬化患者认知功能相关的文章,检索词“multiplesclerosis,cognitivefunctionorneuropsychology”。限定文章语言种类为English,研究对象为人类。同时计算机检索中国期刊全文数据库2000-01/2004-12期间的相关文章,限定文章语言种类为中文,检索词“多发性硬化,认知功能”。资料选择:对资料进行初审,选取有关多发性硬化患者认知功能损害的特点、相关影响因素及与生活功能相关性方面的文献,筛除关于多发性硬化病因、病理方面的研究及综述文献。对剩余的文献开始查找全文,分析、总结研究内容。f资料提炼:共收集到英文文献259篇,其中研究文章201篇,综述58篇。30篇文献符合纳入标准。收集到的中文文献3篇,纳入0篇。资料综合:多发性硬化不同形式、不同程度认知损害发生率约为45%～65%,其发生及严重程度和躯体残疾状况无明显相关。多发性硬化患者在近记忆、注意力、信息处理速度、视空间能力、执行功能等方面损害明显,而整体智力水平和语言能力相对保存,其认知功能损害和患者的生活能力下降有关。多发性硬化认知损害的检测主要运用神经心理学的方法,常用的有多发性硬化认知损害筛查测验、加利福尼亚词语学习、Rey听觉词语学习测验、符号数字模式测验、言语流畅性测验、威斯康星卡片分类测验,Stroop测验和数字广度测验等。结论:多发性硬化患者认知功能损害以记忆、信息处理速度、执行功能为主,整体认知功能及语言功能相对保存。认知功能损害影响患者的生活功能。

OBJECTIVE： To investigate the characteristics and related influencing factors of cognitive impairment in patients with multiple sclerosis, and study the effect of cognitive impairment on their living function. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the cognitive function of patients with multiple sclerosis published in English from January 2000 to December 2004 by using the keywords of “multiple sclerosis, cognitive function or neuropsychology”, the subjects were human. Chinese relevant articles published between January 2000 and December 2004 were searched in Chinese journals full-text database, the keywords were “multiple sclerosis, cognitive function”. STUDY SELECTION： Preliminary check was implemented. The articles about the characteristics of cognitive impairment, its related influencing factors, and its correlation with living function in patients with multiple sclerosis were selected, and studies about the etiology and pathology of multiple sclerosis were screened. The full-texts of the rest articles were scanned, and the contents were analyzed and summarized. DATA EXTRACTION： Totally 259 English literatures were collected, including 201 investigative articles and 58 reviews, 30 of them accorded with the inclusive criteria. Three Chinese articles were collected, and none was included. DATA SYNTHESIS： The incidence rate of cognitive dysfunction in patients with multiple sclerosis of different forms and different severity was 45%-65%. The occurrence and severity had no obvious correlation with the disabled status of body. The patients with multiple sclerosis had obvious impairments in recent memory, attention, speed of information processing, ability of visual space and performance function, and their general intellectual level and language ability were reserved relatively, their cognitive dysfunction was associated with the decrease of the living ability. The cognitive dysfunction of multiple sclerosis was mainly detected with neuropsychological methods. CONCLUSION： The patients with multiple sclerosis have obvious impairments in recent memory, speed of information processing and performance function, and their general intellectual level and language ability are reserved relatively. Cognitive dysfunction can negative effects on the patients＇ living function.