帕金森病患者认知功能障碍与抑郁和脑白质疏松症的关系

Relationship Between Cognitive Dysfunction of Parkinson's Disease,Depression and Leukoaraiosis

目的:探讨帕金森病(PD)患者的认知功能障碍与抑郁和脑白质疏松症(LA)的关系。方法:采用简易精神状态量表(MMSE)和临床记忆量表(CMS)、汉密尔顿抑郁量表(HAMD)检查70例PD患者及40例健康对照者的认知功能及情感状态,并比较其认知障碍的程度。结果:①PD组、PD合并LA组、抑郁组MMSE及CMS评分除无意义图形再认外均显著低于对照组(P<0.05～0.01);②PD合并LA组MMSE及CMS评分均显著低于无LA组(P<0.01);③抑郁组MMSE及CMS评分除无意义图形再认外均显著低于非抑郁组(P<0.01);⑷PD合并LA组中度认知功能障碍5例(27.8%),痴呆11例(61.1%);PD抑郁组中度认知功能障碍6例(17.6%),痴呆13例(38.2%)。结论:PD合并LA及伴发抑郁状态者更易产生认知功能障碍,合并LA组存在较全面而严重的认知功能障碍,抑郁组认知功能的损害主要表现为词语记忆的损害。

Objective： To study the relation amony cognitive dysfunction, depression and leukoaraiosis （LA） in patients with Parkinson＇s disease（PD）. Methods： Mini-mental state examination（MMSE）, clinical memory scale（CMS） and Hamilton Depression scale （HAMD） were used to evaluate the cognitive and emotion dysfunction in 70 patients with PD and 40 healthy controls. Results： ①The scores of MMSE and CMS in PD group, PD combined LA group, PD with depression （PDD） group, with the exception of meaning less figures, were significantly lower than those in healthy control group （P〈 0.05-0.01）. ②The scores of MMSE and CMS in PD combined LA group were significantly lower than those in PD without LA group（P〈0.01）. ③The scores of MMSE and CMS in PDD group, with the exception of meaning less figures, were significantly lower than those in PD without depression group （P〈0.01）. ④There were 5 cases （27.8%） with midrange cognitive dysfunction and 11 cases （61.1%） with dementia in PD combined LA group and 6 cases （17.6%） with midrange cognitive dysfunction and 13 cases （38.2%） with dementia in PDD group. Conclusion： Patients with PD combined LA and PDD are more likely to get cognitive dysfunction. Patients with PD combined LA are associated with global cognitive function impairment. Patients with PD depression are more likely to get verbal memory impairment.