【摘要】 目的:调查分析广州地区帕金森病(Parkinson’s disease,PD)患者认知功能障碍的临床特点及其影响因素。方法:对广州地区六家医院107例PD患者进行问卷调查,采用蒙特利尔认知评估量表(MoCA)进行认知测评,并进行帕金森病统一评分量表(UPDRS)、汉密尔顿抑郁量表(HRSD)评分及Hoehn-Yahr(H-Y)分级评估,采用Spearman相关分析探讨影响认知功能的相关因素。结果:有83.2%的PD患者存在认知功能障碍,其中以短时记忆、语言功能最易受损,其次为视空间/执行能力、注意力、抽象思维,发生率均超过50%;PD患者MoCA评分与患者受教育年限呈正相关(r_s=0.542,P<0.05),与年龄、发病年龄、UPDRSⅡ-Ⅳ评分、H-Y分级及HRSD评分呈负相关(r_s分别为-0.257,-0.266,-0.472,-0.381,-0.357,均P<0.05),与病程、起病方式无关,服用与未服用多巴胺受体激动剂的PD患者间MoCA评分有显著差异(P<0.05)。结论:广州地区PD患者认知功能障碍的发生率较高,以短时记忆、语言最易受损;高龄、高发病年龄、运动障碍严重、抑郁状态的PD患者认知功能易受影响。更多还原

【Abstract】 Objective:To investigate the clinical characteristics and correlative factors of cognitive impairment in Guangzhou patients with Parkinson’s disease(PD ).Methods:A questionnaire survey was conducted among 107 PD patients registered to 6 hospitals in Guangzhou.Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive impairment in these patients.The clinical phenotypes of PD were assessed by Unified Parkinson’s Disease Rating Scale(UPDRSⅡ-Ⅳ),Hamilton Depression Scale(HRSD) and Hoehn-Yahr staging(H-Y).The relationship between the cognitive impairment and its correlative factor were analyzed by Spearman correlation analysis.Results:The incidence of cognitive impairment was 83.2%in PD patients.Among them,the cognitive domains of short-term memory,language were most frequently affected, followed by impaired visuospatial/executive capacities,attention,and abstract thinking which were found in over 50%of the patients.The education years were positively correlated with MoCA score(r_s =0.542,P<0.05),and negatively correlated with patient age,age at onset,UPDRSⅡ-Ⅳscore,H-Y staging and HRSD score(r_s = -0. 257,- 0.266,- 0.472,-0.381,- 0.357,all P<0.05 ).There was no correlation between MoCA score and duration or onset pattern of PD.The mean MoCA score was significantly different between PD patients on and not on dopamine agonists(P<0.05).Conclusion:Cognitive impairment is a relatively common complication of PD in Guangzhou,which most frequently involves short-term memory and language capacities.PD patients with advanced or high-risk age,severe movement disorder,and depression may be more vulnerable to cognitive function impairment.更多还原