并存非运动症状的帕金森病患者轻度认知功能障碍发生情况及危险因素分析

The occurrence and risk factors of mild cognitive impairment in patients with Parkinson's disease with non motor symptoms

目的探讨并存非运动症状的帕金森病(PD)患者轻度认知功能障碍(MCI)发生情况及危险因素分析。方法选取2012年3月至2015年9月本院收治的并存非运动症状的PD患者86例,其中男性45例,女性41例,将MoCA评分<26分的44例患者纳入PD-MCI组,MoCA≥26分的42例患者则纳入PD-NC组(认知功能正常),由3名以上神经科培训的专业人员分别对两组患者进行UPDRS评价、H-Y分级评价、NMSQ评价、MoCA评价,根据各量表的评价结果分析探讨PD患者发生MCI的危险因素。结果 PD-MCI组与PD-NC相比,认知功能方面在视空间技能(t=6.391,P<0.01)、执行功能(t=6.048,P<0.01)、抽象思维(t=6.762,P<0.01)、记忆(t=-4.247,P<0.01)这几项差异有统计学意义;非运动症状方面在兴趣丧失(χ2=5.957,P=0.015)、焦虑抑郁(χ~2=4.643,P=0.031)、睡梦中肢体活动(χ~2=4.43,P=0.035)的发生率存在统计学差异(P<0.05);统计分析得出PD患者发生MCI的主要因素为兴趣丧失和睡梦中肢体活动。结论早期未治疗的PD患者的认知功能障碍的发生与兴趣丧失以及梦境中肢体活动存在一定的联系。

Objective To investigate the occurrence and risk factors of mild cognitive impairment （ MCI ） in patients with Parkinson＇s disease （ PD ） with non motor symptoms. Method Between March 2012 and September 2015, 86 patients with non-motor symptoms of PD in our hospital were selected,including 45 male PD patients and 41 female patients with PD, 44 cases of MoCA〈26 scores were included in the PD-MCI group, 42 cases of MoCA I〉 26 scores were included in the PD -NC group （ normal cognition ） , by more than 3 after the neurological training of professionals of two groups of patients with UPDRS and H-Y evaluation,classification evaluation, NMSQ evaluation, MoCA evaluation,according to the analysis the results of the evaluation scale to explore the risk factors in patients with PD MCI. Results Compared with PD-MCI group and PD-NC, cognitive function in visual spatial skills （ t=6.391,P〈0.01 ） and executive function （ t=6.048, P〈0.01 ） ,abstract thinking （ t=6.762, P〈0.01 ） , memory （ t=- 4.247, P〈0.01 ） which had statistical difference; Non-motor symptoms in the loss of interest （χ^2=5.957,P=0.015 ） depression and anxiety （χ^2=4.643, P=0.031 ） , physical activity during sleep （ χ^2=4.43, P=0.035 ） there was a significant difference between （ P〈0.05 ） ; Statistical analysis of the main factors in patients with PD MCI for physical activity and sleep loss of interest. Conclusion There was a certain relationship between the occurrence of cognitive impairment and the loss of interest and the activities of the body of the dream in the early treatment of PD patients without treatment.