首次确诊帕金森病患者情绪和认知功能障碍的关系

目的观察研究首次确诊帕金森痛患者情绪和认知功能障碍之间的关系。方法60例首次确诊帕金森病（PD）患者，采用简易智能状态检查量表（MMSE）和词ir-流畅性测验评定患者的认知功能；采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定患者的情绪障碍。采用统一帕金森病评分量表（UPDRS）和改良Hoehn—Yahr分级评定患者的帕金森病严重程度。结果（1）60例首次确诊PD患者改良H0ehn～Yahr分级显示：I级11例，Ⅱ级32例，Ⅲ级16例，Ⅳ级1例。其中具有抑郁障碍患者28例，占46．7％；具有焦虑障碍患者20例，占33．3％，20例焦虑障碍PD患者都具有抑郁障碍。（2）60例首次确诊PD患者中，具有认知功能障碍患者23例，占38．3％；MMSE评分和词汇流畅性测验评分均与病程呈负相关，差异具有统计学意义（r分别为-0．42，-0．46；P〈0．05）。（3）60例首次确诊PD患者HAMD评分和MMSE评分及词汇流畅性测验评分呈负相关，差异具有统计学意义（r分别为-0．69，-0．76；P〈0．01）。PD患者HAMA评分和MMSE评分及词汇流畅性测验评分亦呈负相关，差异具有统计学意义（r分别为～0．60，-0．68；P〈0．01）。结论首次确诊PD患者多为轻、中度患者，早期即表现情绪障碍和认知功能障碍，且两者具有高度相关性。

The relationship of emotion and cognitive impairment in the first-- time diagnosed Parkinson disease

Objective To investigate the relationship of emotion and cognitive impairment in the first-- time diagnosed patients suffered from Parkinson disease （PD）. Methods A total of 60 PD patients were included in this study. Mini--mental status examination （MMSE） and word fluency test were used to evaluate the cognitive functions of the patients. Emotion status was evaluated using Hamilton depres- sion scale （HAMD） and Hamilton anxiety scale （HAMA）. The severity level of Parkinson disease was evaluated with unified Parkinson disease rating scale and modified Hoehn- Yahr classification. Results （1）11 patients were in stage one, 32 in stage two, 16 in stage three, and 1 in stage four among 60 first--time diagnosed PD patients being classified by modified Hoehn--Yahr classification. There were 28 patients out of 60 PD patients （46.7%） with depressive disorder; 20 patients out of 60 PD pa- tients （33.3%） had anxiety disorder and all of them showed depression. （2）23 out of 60 PD patients （38.3%） showed cognitive impairment. MMSE scores and word fluency test scores inversely correlated with disease duration respectively （r =-- 0. 42,P 〈 0.05; r =- 0.46,P 〈 0. 05 respectively）. （3） HAMD scores of 60 first--time diagnosed PD patients inversely correlated with MMSE scores and word fluency test scores respectively （r =-0.42 ,P 〈0. 05 ;r =-0.69 ,P 〈 0. 001 respectively）. HA- MA scores of the PD patients also inversely correlated with MMSE scores and word fluency test scores respectively （r =- 0.60,P 〈 0.01 ;r =- 0.68,P 〈 0. 001 respectively）. Conclusions Most of the first --time diagnosed PD patients are mild or moderate in severity. Emotion and cognitive disorder are seen in the early stage of PD and highly correlated with each other.