帕金森病患者嗅觉功能与认知功能和运动症状相关性分析  

Correlation analysis of olfactory function with cognitive function and motor symptoms in patients with Parkinson’s disease

作　　者：陈兴 邢峰博 刘婷婷[1] 孙金梅 莫雨婷 杨倩 汪凯[1] 胡盼盼[1] CHEN Xing;XING Feng-bo;LIU Ting-ting;SUN Jin-mei;MO Yu-ting;YANG Qian;WANG Kai;HU Pan-pan(Department of Neurology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China;Department of Neurology,Nanjing Jiangning Hospital,Nanjing 211100,Jiangsu,China)

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022 [2]江苏省南京市江宁医院神经内科,211100

出　　处：《中国现代神经疾病杂志》2021年第10期887-892,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家重点研发计划项目(项目编号:2018YCF1314200)。

摘　　要：目的探讨原发性帕金森病患者嗅觉功能与认知功能和运动症状的相关性。方法纳入2018年8月至2019年10月在安徽医科大学第一附属医院诊断与治疗的152例原发性帕金森病患者,采用中国气味识别测试(CSIT)评估嗅觉识别功能并根据测试结果分为嗅觉正常组(62例)和嗅觉障碍组(90例),同时采用统一帕金森病评价量表第三部分(UPDRSⅢ)评估运动功能,蒙特利尔认知评价量表(MoCA)北京版评估认知功能,汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估抑郁和焦虑症状,n-back测试评估视空间工作记忆能力。Pearson相关分析和Spearman秩相关分析探讨帕金森病患者嗅觉功能与认知功能和运动症状的相关性。结果与嗅觉正常组相比,嗅觉障碍组患者CSIT-self评分(Z=-2.081,P=0.037)和CSIT-OI评分(t=13.966,P=0.000)降低,MoCA总评分(t=3.008,P=0.003)以及视空间执行功能(Z=-2.277,P=0.023)、命名(Z=-2.397,P=0.017)、注意力(Z=-3.203,P=0.001)、语言(Z=-2.229,P=0.026)、延迟记忆(Z=-2.426,P=0.015)等分评分均降低,1-back测试(t=2.341,P=0.027)和2-back测试(t=2.406,P=0.024)正确率降低,0-back测试(t=-2.309,P=0.029)和2-back测试(t=-2.314,P=0.029)反应时间延长。相关分析结果显示,帕金森病患者嗅觉识别功能评分与MoCA总评分呈正相关关系(r_(s)=0.298,P=0.000)。结论帕金森病患者嗅觉功能与认知功能密切相关,存在嗅觉障碍的帕金森病患者视空间工作记忆能力较差,应该更加关注此类患者的认知功能和视空间工作记忆能力。Objective To investigate the correlation of olfactory function and cognitive function and motor symptoms in patients with primary Parkinson’s disease(PD).Methods Total 152 patients with PD diagnosed and treated were recruited from August 2018 to October 2019 in The First Affiliated Hospital of Anhui Medical University.The Chinese Smell Indentification Test(CSIT)was used to evaluate the olfactory recognition function.According to the test results,patients were divided into the normal olfactory group(n=62)and the olfactory disorder group(n=90).The Unified Parkinson’s Disease Assessment ScaleⅢ(UPDRSⅢ)was used to evaluate the motor function,the Montreal Cognitive Assessment Scale(MoCA)Beijing edition was used to evaluate the degree of cognitive function,the Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA)were used to assess the patients’depression and anxiety levels.Patients’visual spatial working memory function were tested by the n-back test.Pearson correlation analysis and Spearman rank correlation analysis were used to investigate the correlation between olfactory function with cognitive function and motor symptoms in patients with PD.Results CSIT-self score(Z=-2.081,P=0.037)and CSIT-OI score(t=13.966,P=0.000)were lower in patients with anosmia than in those with normal smell.Overall MoCA score(t=3.008,P=0.003),as well as the scores of visuospatial executive function(Z=-2.277,P=0.023),naming(Z=-2.397,P=0.017),attention(Z=-3.203,P=0.001),language(Z=-2.229,P=0.026),delayed memory(Z=-2.426,P=0.015)were all decreased.The accuracy of 1-back test(t=2.341,P=0.027)and 2-back test(t=2.406,P=0.024)decreased,and the response time of 0-back test(t=-2.309,P=0.029)and 2-back test(t=-2.314,P=0.029)increased.Correlation analysis showed that olfactory function score was positively correlated with total MoCA score(r_(s)=0.298,P=0.000).Conclusions The olfactory function of PD patients is closely related to cognitive function,PD patients with olfactory disorder have poor visual spatial workin

关 键 词：帕金森病 嗅觉障碍 认知障碍 运动障碍 空间记忆 

分 类 号：R742.5[医药卫生—神经病学与精神病学]