帕金森病患者认知功能两年随访

A 2-year follow-up study on cognitive function of patients with Parkinson＇s disease

目的 随访研究帕金森病（parkinson＇s disease,PD）患者认知功能的变化并研究患者认知功能下降的相关因素.方法 应用蒙特利尔认知评估量表（Montreal Cognitive Assessment,MoCA）评估70例原发性PD患者的认知功能,联合应用PD相关量表评定其运动症状及抑郁、焦虑等非运动症状,并收集患者与PD相关的个人信息.2012年对患者进行随访,再次进行各量表评估,收集两次调查数据进行分析.结果 两年后,患者MoCA总分从（24.79±4.07）分降至（21.69±5.22）分,差异有统计学意义（P＜0.01）,其中MoCA 7个认知领域中5个认知领域总分下降达到统计学差异.PD运动亚型是认知功能下降最主要的预测因素（P＜0.01）.与震颤（tremor dominant,TD）型比较,姿势和步态异常（postural instability gait difficulty,PIGD）型在MoCA总分及命名、语言、抽象和定向领域下降更加明显.结论 PD患者经过两年病程发展认知功能有明显下降,应及早注意鉴别患者运动亚型、识别患者认知功能的下降并进行干预.

Objective To investigate the change and its related risk factors of cognitive function of patients with Parkinson＇s disease（PD）.Methods The cognitive function of 70 idiopathic PD patients were assessed with Montreal cognitive assessment scale （MoCA）,and other PD related neuropsychological test batteries were used to evaluate their movement symptoms and non-movement symptoms such as depression and anxiety.Patients＇ personal information were collected at the same time.They were reassessed after 2 years.Results As the disease progressed,the MoCA score of the PD patients significantly reduced from （24.79±4.07） points to （21.69±5.22） points （P〈0.01）.Seven subdomains of MoCA were attenuated,and 5 of them reached statistical significance.Motor subtype was a main predictor of the outcome of the cognitive impairment in PD.Scores of MoCA total score,naming,language,abstract and directional domains reduced more notably in patients with postural instability gait difficulty（PIGD） than those in the tremor dominant（TD） patients.Conclusion Cognitive function of PD patients decreases obviously after 2 years.The patients＇ cognitive impairment should be identified and intervened as soon as possible,especially the patients with PIGD.