进行性核上性麻痹和多系统萎缩的认知和影像特征  

Cognitive and imaging characteristics of progressive supranuclear palsy and multiple system atrophy

作　　者：贾培飞 纪勇 JIA Peifei;JI Yong(The Second Affiliated Hospital of Baotou Medical University,Baotou 014030,China;School of Neurosurgery and Neuro Rehabilitation,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]包头医学院第二附属医院,内蒙古包头014030 [2]天津医科大学神经内外科及神经康复临床学院,天津300070

出　　处：《中国实用神经疾病杂志》2023年第4期476-481,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 分析进行性核上性麻痹(PSP)和多系统萎缩(MSA)的认知特征和影像学特点。方法连续纳入2018-01—2021-01天津市环湖医院76例很可能的PSP患者,85例很可能的多系统萎缩的帕金森亚型(MSA-P型)患者。收集所有患者的一般资料及临床资料,并完成MMSE、MoCA及影像评估。通过分析2组在整体认知及认知分领域的差异,绘制ROC曲线,评估MMSE和MoCA在2组中的特异度和敏感度。结果 PSP与MSA-P患者在发病年龄、性别、高血压、糖尿病、整体认知方面差异有统计学意义(P<0.05),MMSE分领域差异主要表现在复述和视空间(P<0.05),MoCA分领域差异主要表现在视空间与执行、语言和抽象方面(P<0.05)。MMSE鉴别PSP与MSA的截点值26(AUC=0.68,敏感度65.3%,特异度81.1%,P<0.05),MoCA鉴别PSP与MSA的截点值19(AUC=0.73,敏感度0.70%,特异度60%,P<0.05)。结论 PSP认知功能损害程度较MSA重,MMSE和MoCA评分及特征性影像成像可用于区分MSA和PSP。Objective To analyze the cognitive characteristics of progressive supranuclear palsy and multiple system atrophy.Methods From January 2018 to January 2021,76 patients with probable PSP and 85 patients with MSA-P were enrolled from Tianjin Huanhu Hospital.General and clinical data of all patients were collected,and the corresponding scale evaluation was completed.The specificity and sensitivity of MMSE and MoCA in the two groups were evaluated by analyzing the differences between the two groups in overall cognition and cognitive sub domains,drawing ROC curves.Results There were significant differences in patients with PSP and MSA-P in age,sex,hypertension,diabetes,and overall cognition(P<0.05).The differences in MMSE sub domains were mainly in retelling and visual space(P<0.05).The differences in MoCA sub domains were mainly in visual space and execution,language and abstraction(P<0.05).The cutoff value of MMSE for identifying PSP and MSA was 26(AUC was 0.68,sensitivity was 65.3%,specificity was 81.1%,P<0.05),and that of MoCA for identifying PSP and MSA was 19(AUC was 0.73,sensitivity was 0.70%,specificity was 60%,P<0.05).Conclusion The cognitive impairment of PSP is more severe than that of MSA.MMSE and MoCA scores can be used to distinguish MSA and PSP.

关 键 词：进行性核上性麻痹 多系统萎缩 帕金森病 神经退行性帕金森综合征 认知障碍 鉴别诊断 

分 类 号：R741.041[医药卫生—神经病学与精神病学]