50例麻痹性痴呆患者认知障碍特征

Characteristics of cognitive impairment of 50 patients with general paresis of insane

目的探讨麻痹性痴呆(GPI)患者认知障碍的特征。方法选取首都医科大学附属北京地坛医院神经内科确诊的麻痹性痴呆患者50例及同期相匹配的无症状型神经梅毒(ANS)患者50例作为研究对象,采用简易精神状态量表(MMSE)评估各组患者认知障碍情况,比较不同痴呆程度GPI患者量表评分,采用多因素线性回归分析GPI患者MMSE评分的影响因素。结果GPI组患者MMSE总分(22.50±5.26)低于ANS组(28.60±1.56),差异有统计学意义(t=7.852、P<0.001)。两组患者MMSE各分项得分比较显示,GPI组患者定向力(6.78±2.50)、注意力与计算力(3.16±1.82)、回忆力(1.48±1.05)和语言能力(7.28±1.49)等均显著低于ANS组(9.68±0.55、4.30±1.07、2.70±0.54、8.00±0.00),差异均有统计学意义(t=8.006、P=0.000,t=3.811、P<0.001,t=7.271,P<0.001,t=3.428、P=0.001)。中重度GPI患者的定向力、记忆力、回忆力及语言能力等各分项得分低于轻度组,但差异无统计学意义(t=0.791、P=0.433,t=0.350、P=0.728,t=0.250,P=0.804,t=1.452、P=0.153)。多因素线性回归分析显示,年龄影响MMSE评分,GPI患者年龄越大,MMSE评分越低(β=-0.365、P<0.001)。结论麻痹性痴呆患者存在全面性认知功能下降,年龄因素对认知障碍具有影响。

Objective To investigate the characteristics of cognitive impairment of patients with generalized paresis of insane(GPI).Methods Total of 50 patients with general paresis of insane and 50 patients with asymptomatic neurosyphilis(ANS)were selected from the Department of Neurology of Beijing Ditan Hospital,Capital Medical University.Mini-Mental State Examination(MMSE)was used to evaluate the cognitive impairment of each group.The scores of GPI patients with different degrees of dementia were compared.The influencing factors of MMSE score in patients with GPI were analyzed by multivariate linear regression.Results The total score of MMSE in GPI group(22.50±5.26)was significantly lower than that of ANS group(28.60±1.56),with significant difference(t=7.852,P<0.001).The comparison of MMSE scores of each subitem showed that the scores of orientation,attention and computational power,recall ability and language capability in GPI group(6.78±2.50,3.16±1.82,1.48±1.05,and 7.28±1.49)were significantly lower than those of ANS group(9.68±0.55,4.30±1.07,2.70±0.54,and 8.00±0.00),with significant differences(t=8.006,P<0.001;t=3.811,P<0.001;t=7.271,P<0.001;t=3.428,P=0.001).The scores of orientation,memory,recall and language ability in patients with moderate and severe GPI were significantly lower than those in mild group,but without significant differences(t=0.791,P=0.433;t=0.350,P=0.728;t=0.250,P=0.804;t=1.452,P=0.153).Multivariate linear regression analysis showed that age affected MMSE score.The older the GPI patients,the lower the MMSE score(β=-0.365,P<0.001).Conclusions There was a general decline of cognitive function in patients with general paresis of insane,and age had an effect on cognitive impairment.