帕金森病患者认知功能障碍的发生率及影响因素

Incidence and related factors of Parkinson' s disease with cognitive dysfunction

目的：研究帕金森病（ PD）患者认知功能障碍的发生率、临床特点及其相关影响因素。方法：应用蒙特利尔认知评估（MoCA）量表对52例PD患者（PD组）和58例健康对象（对照组）进行评定，探讨PD组患者认知功能障碍的发生率、临床特点及PD患者认知功能障碍与年龄、病程、H-Y分级、UPDRS评分的关系。结果：PD组Mo-CA评分（20．28±4．16）低于对照组（26．28±3．61）（t ＝8．036，P ＜0．001），PD 组患者认知功能障碍发生率（57．7％，30例）高于对照组（10．3％，6例）（χ2＝19．200，P＜0．001）。 PD患者认知功能障碍的主要特点表现为注意与集中、执行功能、延迟回忆、语言、视结构技能、抽象思维和定向力等下降。 Logistic回归分析显示PD组认知功能障碍与患者病情严重程度（H-Y分级）、病程、UPDRS（第1部分）评分、UPDRS（第2部分）评分有关（OR：5．464，6．172，1．138，1．305；95％CI：1．915～10．136，0．068～0．872，1．017～1．358，1．316～11．014）。结论：PD患者认知功能障碍发生率高，临床表现多样，其与病程、病情轻重、URPDS评分有关。

Aim：To study the incidence , clinical characteristics and related factors of cognitive dysfunction in Parkin-son′s disease（PD）.Methods：A total of 52 patients with Parkinson′s disease （PD group） and 58 healthy patients （nor-mal group） were assessed by Montreal cognitive assessment （MoCA） scale,to study the incidence of cognitive dysfunction , clinical characteristics in PD patients and the relationship between the PD patients with cognitive dysfunction and age , du-ration, Hoehn-Yahr grade, UPDRS score.Results：The MoCA score in PD group was lower than that in normal group （t=8.036,P〈0.001）, the incidence of cognitive dysfunction was 57.7% in the PD group（χ2 =19.200,P〈0.001）.The main features of cognitive dysfunction in PD patients showed attention and concentration , executive functions , memory, de-layed recall, language skills, visual ability, abstract thinking and ability of orientation , retardation, etc.Logistic regression analysis showed that cognitive dysfunction in PD group was positively related with the severity of disease condition （ H-Y classification）, duration, UPDRS （Part Ⅰ） score and UPDRS （Part Ⅱ） score（OR：5.464,6.172,1.138,1.305;95%CI：1.915-10.136,0.068-0.872,1.017-1.358,1.316-11.014）.Conclusion： The incidence of cognitive dysfunc-tion in PD patients is high .There are many forms of clinical manifestations , and the extent of these manifestations is corre-lated with disease duration , severity and UPDRS score .