帕金森病伴轻度认知障碍患者生活质量及影响因素分析

Study on quality of life and influential factors in patients with Parkinson's disease combined with mild cognitive impairment

目的探讨帕金森病(PD)伴发轻度认知障碍(MCI)患者生活质量状况及其相关影响因素。方法65例PD患者分为轻度认知障碍组(PD-MCI)和无认知障碍组(PD-NCI);应用统一PD评分量表(UPDRS)、Hoehn-Yahr(H-Y)分期、简易精神状态量表(MMSE)、蒙特利尔认知评估量表(Mo CA)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、基础日常生活能力问卷(BADL)和39项帕金森病生活质量问卷(PDQ-39)对患者进行评估。结果 2组患者发病年龄和受教育程度,差异具有统计学意义(P均<0.05);PD-MCI组患者在Mo CA各个维度评分均显著低于PD-NCI组(P均<0.01);2组患者H-Y分期、UPDRS-Ⅲ、PDQ-39、UPDRS-Ⅱ及BADL比较均有统计学差异(P均<0.05);Mo CA评分与H-Y分期、UPDRS-Ⅲ、PDQ-39、HAMD、UPDRS-Ⅱ呈负相关(r=-0.32、-0.23、-0.42、-0.49、-0.25,P<0.05);与BADL呈正相关(r=0.40,P<0.05)。结论PD-MCI患者认知功能障碍与运动障碍相关,严重影响日常生活能力。

Objective To investigate the potential influencing factors of quality of life in patients with Parkinson＇s disease（ PD） combined with mild cognitive impairment（ MCI）. Methods A total of 65 patients with PD were divided into PD-MCI group（ n = 31,the patients with mild cognitive impairment） and PD-NCI group（ n = 34,the patients without cognitive impairment）. The quality of life was evaluated by unified Parkinson＇s disease rating scale（ UPDRS）,HoehnYahr（ H-Y） stage,mini-mental state examination（ MMSE）,Montreal cognitive assessment（ Mo CA）,Hamilton depression rating scale（ HAMD）,Hamilton anxiety rating scale（ HAMA）,basic ability of daily living questionnaire（ BADL） and Parkinson＇s disease questionnaire（ PDQ-39）. Results The differences in age and education status were significant between two groups（ P〈0. 05）. The scores of Mo CA in PD-MCI group were lower than those in PD-NCI group（ P〈0. 01）.There were significant differences in the scores of H-Y stage,UPDRS-Ⅲ,PDQ-39,UPDRS-Ⅱ and BADL between two groups（ P〈0. 05）. The scores of Mo CA in PD-MCI group were negatively correlated with H-Y stage,UPDRS-Ⅲ,PDQ-39,HAMD and UPDRS-Ⅱ（ r =-0. 32,-0. 23,-0. 42,-0. 49,-0. 25,P〈0. 05,respectively）,and positively correlated with BADL（ r = 0. 40,P〈0. 05）. Conclusions The results indicate the correlation between cognitive impairment and motor dysfunction,which has major impact on daily life of the patients with PD.