帕金森病患者轻度认知功能障碍评估

Evaluation of the mild cognitive impairment in Parkinson's disease

目的：探讨蒙特利尔认知评估量表（Mo CA）和简易智能状态量表（MMSE）联合测评帕金森病（Parkinson＇s disease,PD）患者轻度认知功能障碍（MCI）的敏感性及可行性。方法：应用Mo CA和MMSE分别测评60例PD患者和30名对照组健康体检者。结果：PD组Mo CA和MMSE测评结果和对照组比较差异有统计学意义（P〈0.05）;帕金森UPDRS评分轻、中和重度组患者MMSE与Mo CA评分均明显低于对照组,且病情分度越严重MMSE、Mo CA评分亦越低（P〈0.01）;Hoehn-Yahr分级1-5期组MMSE和Mo CA评分均明显低于对照组（P〈0.01）;而1-5期组间MMSE和Mo CA评分差异均有统计学意义（P〈0.05-P〈0.01）,PD组Mo CA评分视空间/执行功能、抽象能力和记忆力评分均显著低于对照组（P〈0.01）。结论：Mo CA和MMSE联合应用可能有利于早发现PD患者的MCI,Mo CA在视空间/执行功能、抽象能力和记忆力等局部认知功能缺损敏感性测评优于MMSE,Mo CA可能为PD患者MCI的早期发现、防治提供无创性优先筛选依据。

Objective： To discuss the sensitivity and feasibility of Montreal Cognitive Assessment（ Mo CA） and Mini-Mental State Examination（ MMSE） in evaluating the mild cognitive impairment（ MCI） of patients with Parkinson＇s disease（ PD）. Methods： Sixty PD patients and 30 control patients were evaluated using the Mo CA and MMSE. Results： The difference of evaluation result of Mo CA and MMSE between the PD group and control group was statistically significant（ P〈0. 05）. The scores of Mo CA and MMSE in patients with light,medium and severe score of UPDRS were significantly lower than those in control group,and the more severe the disease was,the lower the scores of Mo CA and MMSE were（ P〈0. 01）. The scores of Mo CA and MMSE in patients with satge 1 to 5 of Hoehn-Yahr staging were significantly lower than that in control group（ P〈0. 01）; and the differences of the scores of Mo CA and MMSE in patients with satge 1 to 5 were statistically significant（ P〈0. 01）. The Mo CA scores of the space/executive function,abstract ability and memory in PD group were significantly lower than those in control group. Conclusions： The application of Mo CA combined with MMSE can be beneficial for early finding the MCI in PD patients,and the sensitivity of Mo CA in space/executive function,abstract ability and memory are better than that of MMSE. Mo CA can provide the basis in early finding and nonivasive screening the PD patients with mild cognitive impairment.