帕金森病患者的轻度认知功能障碍

Mild cognitive impairment among the patients with Parkinson's disease

目的评估帕金森病(Parkinson’s disease,PD)患者的认知功能状态,分析帕金森病合并轻度认知功能障碍(Parkinson’s Disease with Mild Cognitive Impairment,PD-MCI)的特点。方法纳入PD患者64例,采用神经心理测试组评估其注意、视空间、执行和记忆等认知域的功能。结果本组PD患者中,认知功能正常24例(37.5%),PD-MCI 30例(46.9%),帕金森病痴呆10例(15.6%)。在PD-MCI患者中,单个认知领域轻度损害(60.0%)较多个认知域型轻度认知损害(40.0%)更常见,累及较多的认知域依次为记忆(20例,66.7%),执行(13例,43.3%),视空间(12例,36.7%)。早期PD患者PD-MCI发生率为36.4%,痴呆发生率为3.0%;中晚期PD患者PD-MCI发生率为58.1%,痴呆发生率达29.0%,两组差异有显著性(χ2=18.222,P<0.001)。PD患者的病情程度与认知功能状态呈负相关(Spearman相关系数=-0.553,P<0.001)。结论轻度认知功能障碍(mild cogni-tive impairment,MCI)在PD患者中常见,即使在疾病早期,其发生率也较高,其中单个认知领域轻度损害较多个认知域型轻度认知损害更常见。PD患者的病情越严重,认知功能状态越差。

Objective To evaluate the cognitive status of the patients with PD,aimed to analyze the characteristic of PD-MCI. Methods Subjects were administered a neuropsychological test battery following standard procedures to evaluate attention,visuospatial, executive and memory cognitive domains. Results Sixty-four patients with PD were recuited. There were 24（37.5% ）patients with normal cognitive function,30 （46.9%）with MCI and 10 （15.6%）with dementia. Among the patients with MCI, single domain mild cognitive impairment was more common than muhiple domains mild cognitive im- pairment. Memory,executive and visuospatial domains were main cognitive disturbances of PD. The occurrence of MCI and dementia was higher among the patients in late stage of PD than among that in early stage. The cognitive status of the pa- tients was negative correlated with the condition of the disease （ P 〈 0. 001 ）. Conclusions MCI is common in the patients with PD, even among those in early stage of disease, and single domain mild cognitive impairment is more frequent than mul- tiple domains miXd cognitive impairment. The more serious is the condition of the disease,the worse the cognitive status of the patients is.