Wilson病患者认知功能障碍及其危险因素  

Study on cognitive impairment and risk factors in patients with Wilson disease

作　　者：王共强 林康 马心锋 汪世靖 刘力生 韩咏竹 杨任民 WANG Gongqiang;LIN Kang;MA Xinfeng;WANG Shijing;LIU Lisheng;HAN Yongzhu;YANG Renmin(The Affiliated Hospital,Institute of Neurology,Anhui Univesity of Tradition Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学神经病学研究所附属医院神经内科

出　　处：《中国神经精神疾病杂志》2019年第6期321-325,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：安徽中医药大学临床科研基金重点项目(编号:2014lckf02004)

摘　　要：目的探讨Wilson病(Wilson disease,WD)认知功能障碍及相关因素,筛选WD患者认知功能障碍的危险因素为临床干预提供依据。方法应用中文版Addenbrooke认知量表-Ⅲ(The Chinese Version of Addenbrooke's Cognitive Examination-Ⅲ-Chinese,ACE-Ⅲ-C)评定患者认知功能,分析认知功能障碍WD患者在Young量表、Baethel量表及生化指标等与非认知功能障碍患者之间的差异性。通过多元线性逐步回归分析WD患者认知功能障碍的危险因素。结果 72例WD患者中43例(59.7%)存在认知功能障碍,在ACE-Ⅲ-C总分、注意力、记忆力、语言流畅性、视空间因子分4个亚领域及Young评分、Barthel指数评分、血清铜水平与非认知功能障碍患者比较有统计学差异(P<0.01);回归分析显示血清铜水平是影响ACE-Ⅲ-C总分及4个认知亚领域最主要的危险因素(P<0.01),其次是血清锌水平作为次要危险因素参与影响患者语言流畅性和视空间(P<0.05),年龄因素参与影响患者语言流畅性(P<0.05)。结论血清铜、锌水平可能是WD认知功能障碍的主要危险因素,调控WD患者血清铜、锌水平可能是干预认知功能障碍的关键。Objective To explore cognitive impairment and related factors in patients with Wilson disease (WD) and to screen the risk factors of cognitive impairment in order to provide evidence for clinical intervention. Methods The Chinese Version Addenbrooke's Cognitive Examination-III (ACE-III-C) was used to assess the cognitive function. The WD patients with cognitive impairment were analyzed the difference between those with non-cognitive disorders in the Young scale, Baethel scale and biochemical indicators. Risk factors for cognitive impairment in WD patients were analyzed by multiple linear regression. Results Cognitive impairment occurred in 43 (59.7%) of 72 patients with WD. ACE-III-C total score, attention, memory, language fluency, visual spatial factor scores, Young scores, Barthel scores and serum copper levels were significantly different between patients with cognitive impairment and patients with non-cognitive impairment (P<0.01). Linear regression analysis showed that serum copper levels were the most important risk factors for ACE-III-C total score and cognitive subfields (P<0.01). Serum zinc levels as a secondary risk factor of language fluency and visual space (P<0.05). Age-related participation affected language fluency (P<0.05). Conclusions Serum copper and zinc levels may be the main risk factors of cognitive impairment. Modulation of serum copper and zinc levels may be the key for intervention to treat cognitive impairment in WD patients.

关 键 词：WILSON病 肝豆状核变性 认知功能障碍 危险因素 

分 类 号：R742.4[医药卫生—神经病学与精神病学]