画钟试验在帕金森病认知功能损害初筛中的应用

Application of Clock Drawing Test in Screening Cognitive Function Impairment of Parkinson's Disease

目的探讨画钟试验(CDT)在筛查帕金森病(PD)认知功能损害中的应用价值。方法共纳入43例PD患者,记录其年龄、病程、受教育年限、运动功能(UPDRS-Ⅲ)和Hoehn&Yah(rH-Y)分级,并进行CDT、汉密尔顿抑郁量表(HAMD)、简易智能精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)等评估。两组均数比较用t检验,相关分析采用Pearson相关系数分析。结果本组PD患者CDT异常率为48.8%,其中轮廓异常3例(7.0%),数字异常15例(34.9%),指针异常17例(39.5%)。CDT正常组和CDT异常组在年龄、病程、受教育年限和UPRDS-III方面的差异均无统计学意义;而在H-Y分级、MMSE和MoCA方面的差异均有显著性(P<0.01)。CDT与MMSE、MoCA呈正相关,相关系数分别为0.660和0.694,P<0.001;与H-Y分级呈负相关,相关系数为-0.534,P<0.001;与年龄、病程、受教育年限和UPRDS-III等因素不相关(P>0.05)。结论 CDT为简便易行敏感的PD认知功能损害的初筛工具。

Objective To explore the application of clock drawing test （CDT） in screening cognitive function impairment of Parkinson＇s disease （PD）. Methods Forty-three patients with PD were involved into the study, comprehensively evaluated with the series of neuropsychological test including CDT, mini-mental state examination （ MMSE ）, Montreal cognitive assessment （MoCA） and other tests. Results The CDT score of twenty-one patients were less than 3 （48.8%）. The main abnormality of CDT was in the digital part （34.9%） and the finger part （39.5%）. No difference was found in age, disease duration, education years and UPRDS-III between the CDT normal group and the CDT abnormal group （P〉0.05）, while the difference of Hoehn ＆ Yahr scale, MMSE and MoCA between two groups were significant （P〈0.01）. CDT was positively related with MoCA and MMSE （P〈0.01）, and negatively related with Hoehn ＆Yahr scale, while not related with age, disease duration, education and UPRDS-III years （P〉0.05）. Conclusion CDT is a convenient and sensitive cognitive screening test for cognitive function impairment of Parkinson ＇ s disease.