帕金森病运动亚型的认知功能障碍特征研究  

Cognitive dysfunction characteristics of Parkinson's disease motor subtypes: report of 128 cases

作　　者：李静[1,2] 张艳玲[2] 胡晓飞[3] 瞿伟[1] 

机构地区：[1]第三军医大学西南医院临床心理科,全军心理卫生研究中心,重庆400038 [2]第三军医大学西南医院神经内科,重庆400038 [3]第三军医大学西南医院放射科,重庆400038

出　　处：《第三军医大学学报》2015年第22期2285-2288,共4页Journal of Third Military Medical University

摘　　要：目的探讨帕金森病(Parkinson’s disease,PD)不同运动亚型之间的认知功能差异。方法选取2012年11月至2014年11月本院神经内科住院和门诊帕金森病患者128例,按照帕金森病统一评定量表第Ⅲ部分(unified parkinson disease rating scale,UPDRS-Ⅲ)运动评分分为震颤(tremordominant,TD)组38例,强直-运动不能(akinetic-rigid,AR)组47例,混合(mixed)组43例,分别进行简易精神状态量表(mini-mental sate examination,MMSE)和蒙特利尔认知评估量表(montral cogmitive assessment,Mo CA)量表评估,分析各组的认知功能。结果 3组患者MMSE总平均分为(26.94±3.26)分,Mo CA为(21.37±5.11)分,二者呈正相关(r=0.761,P<0.01)。3组间MMSE总分和各分项评分差异均无统计学意义(P>0.05);3组间Mo CA总分(P=0.012)、语言分项(P=0.018)、延迟记忆分项(P=0.003)有统计学差异,其中mixed组、AR组与TD组比较Mo CA总分、语言分项、延迟记忆分项均明显降低(P<0.05),而AR组与mixed组比较无统计学差异(P>0.05)。3组患者经MMSE、Mo CA量表检出认知障碍发病率有统计学差异(P<0.05)。结论帕金森病混合亚型和AR亚型的总体认知功能明显低于TD亚型,其中语言、延迟记忆功能下降更为显著。Objective To investigate the differences of cognitive dysfunction among different motor subtypes of Parkinson＇s disease（ PD）. Methods A total of 128 patients with PD were enrolled randomly from November 2012 to November 2014 in inpatient and outpatient of department of neurology our hospital,and divided into tremor-dominant（ TD） group（ n = 38）,akinetic-rigid（ AR） group（ n = 47）,and mixed group（ n = 43） according to the Unified Parkinson＇s disease rating scale（ UPDRS）-Ⅲ motor scores. The cognitive function of all the patients was assessed with the mini-mental state examination（ MMSE） and Montreal cognitive assessment（ Mo CA） scales. Results The average scores of MMSE and Mo CA of all the patients were 26. 94 ± 3. 262 and 21. 37 ± 5. 110,respectively（ r = 0. 761,P 0. 01）. MMSE total score and single-item score had no differences among the 3 groups（ P 0. 05）. Mo CA total score（ P = 0. 012）,language item（ P = 0. 018） and delayed memory item（ P = 0. 003） showed statistically significant differences among the 3 groups. Compared with the TD group,the AR group and the mixed group showed decrease in the Mo CA total score,language item and delayed memory item（ P 0. 05）,and there was no statistical difference between the AR group and the mixed group（ P 0. 05）. The incidence of cognitive dysfunction could be screened by MMSE and Mo CA scales,and there was statistically significant difference among the 3 groups（ P 0. 05）. Conclusion The overall cognitive function of the mixed subtype and AR subtype of PD is significantly lower than that of the TD subtype,and the language and delay memory declines are more significant.

关 键 词：帕金森病运动亚型 认知功能障碍 蒙特利尔认知评估量表 简易精神状态量表 

分 类 号：R741.02[医药卫生—神经病学与精神病学]