帕金森病认知功能障碍的筛查及恩必普治疗的临床观察

Screening for cognitive impairment in newly diagnosed parkinson's disease and therapeutic efficacy of dl-3-bu-tylphthalide

目的筛查帕金森初诊患者认知功能障碍的患病率,观察恩必普胶囊对帕金森病认知功能障碍的影响。方法随机选取120例门诊帕金森病初诊患者,采用MMSE评分进行认知功能障碍筛查,有认知功能障碍者56例随机分为治疗组和对照组,每组28例。对照组仅采用普拉克索片治疗方案(第1周剂量为0.125 mg,3次/d;第2周剂量0.250 mg,3次/d),治疗组在此基础上加用恩必普胶囊治疗(200 mg/次,3次/d,疗程8周)。治疗前后行简易智能精神状态检查量表(MMSE)评分。结果 120例门诊初诊帕金森病患者中,有认知功能障碍者56例,42例存在轻度认知功能障碍(35%),14例诊断为痴呆(11.7%);对照组用药前MMSE评分为21.1±1.4,治疗后第4周为22.3±1.6,第8周为22.7±2.2,治疗前后MMSE评分差异无统计学意义(P>0.05);治疗组用药前MMSE评分为20.7±2.8,治疗后第4周为22.3±1.6,第8周为22.7±2.2,MMSE评分较治疗前差异具有统计学意义(P<0.05)。结论帕金森病患者中认知功能障碍常见,在疾病早期,其患病率也较高,恩必普胶囊能明显改善帕金森病患者的认知功能障碍。

Objective To investigate the prevalence of cognitive impairment in newly diagnosed Parkinsong disease（PD） patients, and assess the efficacy of dl-3-butylphthalinde in the treatment of cognitive impairment. Methods Total 120 newly diagnosed PD patients were recruited for the general information. Cognitive functions were evaluated using the mini- mental state examination（MMSE） ,and the patients with cognitive impairment were divided into routine group and treat- ment group randomly. Routine group were given Pramipexole alone, the treatment group were given Pramipexole plus dl-3- butylphthalide. Results 42 in 120 newly diagnosed PD patients（35% ） were accompanied by mild cognitive impairment （PD-MCI） ,and 14 eases（ 11.7% ） were diagnosed as dementia（PDD） ;Remarkable MMSE score improvement was found in the treatment group,there was a significant difference between the two groups on MMSE assessments on the week 4th and 8th after treatment. Conclusion Many newly diagnosed PD patients have cognitive impairment;dl-3-butylphthalinde should be regarded as an effective medication in the treatment of cognitive impairment in PD patients.