早期帕金森患者认知水平的长期分析

Long-term Analysis of Cognitive Level of Early Parkinson's Patients

目的探究早期帕金森患者认知水平的长期变化,旨在为临床治疗早期帕金森患者提供相应的建议。方法选取2011年5月—2013年2月期间在该院接受治疗的PD患者168例,作为实验组,选取同时间段内该院职工家属正常体检的人员150名作为对照组,收集患者的一般资料,年龄、性别、发病年龄、病程、教育年限等资料;所有受试者均进行系统评分检查,主要包括蒙特利尔认知评估量表(MoCA)、统一PD评分量表(UPDRSm)、非运动症状问卷(NMSquest)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD),观察5年后两组患者的认知障碍发生率,采用多元线性回归分析5年后影响认知功能下降的因素,对比MoCA评分领域中延迟回忆、注意、抽象变化趋势。结果随访5年后,实验组患者中发生认知障碍的患者为33例,认知障碍发生率为19.64%,对照组患者中发生认知障碍的患者为2例,认知障碍发生率为1.33%,对照组患者的认知障碍发生率低于实验组患者,差异有统计学意义(χ^(2)=27.122,P<0.05);第四年、第五年两组患者MoCA评分对比差异有统计学意义(P<0.05);多元线性回归分析影响早期帕金森患者认知功能下降的因素,结果显示:发病年龄、HAMD量表评分、教育年限在一定程度上影响早期帕金森患者认知功能;两组患者在前3年的MoCA评分领域中延迟回忆、注意、抽象变化趋势对比差异无统计学意义(P>0.05);第四年及第五年两组患者的MoCA评分领域中延迟回忆、注意、抽象变化趋势对比差异有统计学意义(P<0.05)。结论5年后,早期帕金森患者认知功能下降,发病年龄、HAMD量表评分、教育年限在一定程度上影响早期帕金森患者认知功能。

Objective To explore the long-term changes in the cognitive level of early Parkinson’s patients, in order to provide corresponding suggestions for clinical treatment of early Parkinson’s patients. Methods A total of 168 PD patients who received treatment in the hospital from May 2011 to February 2013 were selected as the experimental group. 150 patients who received normal physical examinations from the family members of the staff in the hospital during the same time period were selected as the control group. General data, age, gender, age of onset, years of education, etc.;all subjects were subjected to a systematic scoring check, mainly including Montreal Cognitive Assessment Scale(MoCA), Unified PD Score Scale(UPDRSm), and non-motor symptoms questionnaire(NMSquest), Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), observe the incidence of cognitive impairment in the two groups after five years, and use multiple linear regression to analyze the factors that affect cognitive function decline after five years. Compare the trends of delayed recall, attention, and abstraction in the field of MoCA scoring. Results After five years of followup, 33 patients in the experimental group had cognitive impairment, and the incidence of cognitive impairment was 19.64%. In the control group, there were 2 patients with cognitive impairment, and the incidence of cognitive impairment was 1.33%, the incidence of cognitive impairment in the control group was lower than that of the experimental group,the difference was statistically significant( χ2=27.122,P<0.05);the difference in MoCA scores between the two groups in the fourth and fifth years was statistically significant( P<0.05);Multiple linear regression analysis of factors affecting cognitive function decline in early Parkinson’s patients showed that the age of onset, HAMD scale score, and years of education affected the cognitive function of early Parkinson’s patients to a certain ex-tent;the comparison of delayed recall, attention and abstract change trends in the MoCA score field was not statistically significant difference(P>0.05);the comparison of delayed recall, attention, and abstract change trends in the MoCA score field of the two groups of patients in the fourth and fifth years was statistically significant difference(P<0.05). Conclusion Five years later, the cognitive function of early Parkinson’s patients declines. The age of onset, HAMD scale score, and years of education affect the cognitive function of early Parkinson’s patients to a certain extent.