帕金森病患者神经源性直立性低血压与认知功能障碍的相关性  

The correlation between neurogenic orthostatic hypotension and cognitive impairment in patients with Parkinson's disease

作　　者：陈真真 王鲁阳 李雲娜 张梦 胡雪梅 旃培艳 Chen Zhenzhen;Wang Luyang;Li Yunna(Department of Neurology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院神经内科,武汉453000 [2]华中科技大学同济医学院附属武汉市中心医院老年科,武汉453000

出　　处：《卒中与神经疾病》2025年第1期9-13,26,共6页Stroke and Nervous Diseases

基　　金：武汉市卫生健康委科研基金项目(WX21A08,WZ22Q38)。

摘　　要：目的探索伴或不伴神经源性直立性低血压(Neurogenic orthostatic hypotension,nOH)的帕金森病(Parkinson's disease,PD)患者的临床特征和认知功能损害特点以及nOH与认知功能障碍的关系。方法共纳入125例原发性PD患者,收集患者的临床资料、运动症状和非运动症状量表评分、完整的认知功能评估及影像学资料;完善卧立位血压和心率检测,根据卧立位血压和心率的变化将患者分为nOH(+)组和nOH(-)组;应用多因素协方差分析和Logistic回归分析来确定伴或不伴nOH的PD患者的认知功能损害特点以及nOH与认知功能障碍的关系。结果与nOH(-)组比较,nOH(+)组的PD患者在运动和非运动症状方面的临床表现均较差,同时在整体认知功能、视空间功能、执行功能和延迟回忆方面均显著下降;伴nOH的PD患者更容易出现认知功能损害。结论nOH是PD患者认知功能损害的重要临床因素之一。Objective To explore the clinical features and characteristics of cognitive impairment in Parkinson's disease(PD)patients with or without neurogenic orthostatic hypotension(nOH),as well as the relationship between nOH and cognitive impairment.Methods A total of 125 primary PD patients were included.Clinical data,results of motor and non-motor symptom scales,complete cognitive function assessments and imaging data were collected.The prone-standing blood pressure and heart rate tests were perfected,and the patients were divided into nOH(+)group and nOH(-)group according to the changes of blood pressure and heart rate in lying position and standing position.Multifactor analysis of covariance and logistic regression analysis were applied to determine the cognitive impairment characteristics in patients with PD with or without nOH and the relationship between nOH and cognitive impairment.Results Compared to patients in the nOH(-)group,PD patients with nOH(+)exibited poorer clinical performance in both motor and non-motor symptoms,and patients in the nOH(+)group showed significant decreases in overall cognitive functioning,visuospatial functioning,executive functioning,and delayed recall.PD patients with nOH(+)are more likely to experience cognitive impairment.Conclusion nOH is an important clinically factor of cognitive impairment in PD patients.

关 键 词：帕金森病 神经源性直立性低血压 认知功能障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R742[医药卫生—临床医学]