帕金森病认知功能障碍的临床特征及相关因素研究

Study on the clinical features and related factors of cognitive impairment in Parkinson's disease

目的探索帕金森病认知功能障碍的相关因素及其临床特征。方法连续收集419例于2017年3月1日至2017年11月30日期间至中南大学湘雅医院神经内科门诊就诊的临床确诊或临床很可能的帕金森病(PD)患者。采集患者基本信息,进行帕金森病相关运动症状及认知功能评估。据简易精神状态检查量表(MMSE)等将PD患者分为3组:帕金森病不伴认知功能障碍(PDNC)组,帕金森病轻度认知功能障碍(PD-MCI)组及帕金森病痴呆(PD-D)组。结果本组纳入的419例PD患者中,PD-NC患者199例;PD-MCI患者156例,患病率为37.2%;PD-D患者64例,患病率为15.3%。PD-NC、PD-MCI及PD-D三组间性别、病程比较差异无统计学意义(P>0.05)。PDMCI和PD-D组较PD-NC组在发病年龄、年龄、受教育程度、统一帕金森病评定量表(UPDRS)-Ⅱ、UPDRS-Ⅲ、Hoehn-Yahr分期上差异有统计学意义(P<0.05)。三组间在MMSE评分及其各项目上比较差异有统计学意义(P<0.01)。Logistic回归分析显示帕金森病患者发病年龄、受教育程度、病情严重程度为帕金森病认知功能障碍的危险因素(P<0.05)。结论认知功能障碍在帕金森病患者中常见,且与患者发病年龄、受教育程度、病情严重程度相关。

Objective To explore the correlated factors and clinical features of cognitive impari- ment in parkinsong disease （PD）. Methods A total of 419 patients with PD were collected from Xiangya Hospital of Centre-South University during Mar 1st, 2017 to Nov 30th, 2017. The cognitive functions of pa- tients were assessed with the Mini-Mental State Examination （MMSE） , and the basic information and the motor symptoms of 419 PD patients were selected at the same time. The PD patients were classified into three groups according to the MMSE score： PD with no cognitive impairment （PD-NC） , mild cognitive im- pairment in PD （PD-MCI） , and Dementia in PD （PD-D）. The data were analyzed by SPSS 20. 0. Results There were 156 patients with PD-MCI （37.2%） and 64 patients with PD-D （15.3%）. The difference of sex and disease duration among three groups were not statistically significant （ P 〉 0. 05 ）. The significant difference was found among PD-D, PD-MCI, and PD-NC groups in age of onset, age, educational attain- ment, Unified Parkinsong disease Rating Scale （UPDRS）-II score, UPDRS-111 score and Hoehn-Yahr stage （P 〈 0. 05）. There were significant differences among three groups in MMSE score and its items （P 〈 0. 01 ）. Logistics regression analysis found that the age of onset, educational attainment, and Hoehn-Yahr stage were the risk factors of cognitive impairment in PD patients （ P 〈 0. 05 ）. Conclusions Cognitive ira-pairment is common in PD patients, and it is relevant to the age of onset, educational attainment and the se- verity of illness of PD patients.