帕金森病患者认知功能障碍临床分析

目的 通过对帕金森病患者认知功能障碍及相关因素的评价、分析,探讨帕金森病患者发生痴呆的可能机制。方法 采用简易精神状况检查表,对177例帕金森病患者进行认知功能初步筛查,对其中可疑认知功能障碍者进一步行神经心理学测验。结果 177例患者中有33例(18.64％)可疑认知功能障碍,符合痴呆者15例(8.47％)。经Logistic回归分析提示,发病年龄(OR=1.176)与UPDRS日常生活能力评分(OR=1.251)为发生痴呆症的危险因素,而病程和抑郁为非危险因素。结论 帕金森病患者常合并认知功能障碍,早期主要表现为言语流畅性障碍、视空间障碍和记忆障碍,晚期则表现为智能改变和痴呆。神经心理学测验可较为全面、客观地反映患者认知功能。

Clinical analysis of cognitive impairment in Parkinson's disease

Objective To study the potential pathogenesis of dementia in Parkinson's disease (PD) by the assessment of cognitive dysfunction and related factors. Methods Assessment of mental conditions in 177 PD patients was performed with mini-mental state examination (MMSE). Patients suspected of cognitive impairment were further examinated by neuropsychological tests. Results Among the 177 patients 33 (18.64%) cases were suspected as cognitive impairment and 15 (8.47%) cases were diagnosed as dementia. It was found by logistic regression analysis that the onset age of disease (OR = 1.176) and UPDRS II score (OR= 1.251) were the risk factors of dementia in PD but duration of disease (OR = 1.249) and depression (OR = 4.531) were not risk factors. Conclusion It is demonstrated that PD is often associated with cognitive dysfunction, its early manifestations are language fluency dysfunction, visual spatial dysfunction and memory dysfunction, whereas its late symptoms are disturbance of intelligence and dementia. Thus neuropsychological measures could express the patients' cognitive function objectively and comprehensively.