广州地区帕金森病患者认知功能量表测评结果

目的：调查分析广州地区帕金森病（Parkinson’s disease，PD）患者认知功能障碍的临床特点及其影响因素。方法：对广州地区六家医院107例PD患者进行问卷调查，采用蒙特利尔认知评估量表（MoCA）进行认知测评，并进行帕金森病统一评分量表（UPDRS）、汉密尔顿抑郁量表（HRSD）评分及Hoehn—Yahr（H—Y）分级评估，采用Spearman相关分析探讨影响认知功能的相关因素。结果：有83．2％的PD患者存在认知功能障碍，其中以短时记忆、语言功能最易受损，其次为视空间／执行能力、注意力、抽象思维，发生率均超过50％；PD患者MoCA评分与患者受教育年限呈正相关（t=0．542，P〈0．05），与年龄、发病年龄、UPDRSⅡ-Ⅳ评分、H-Y分级及HRSD评分呈负相关（rs分别为-0．257，-0．266，-0．472，-0．381，-0．357，均P〈0．05），与病程、起病方式无关，服用与未服用多巴胺受体激动剂的PD患者间MoCA评分有显著差异（P〈0．05）。结论：广州地区PD患者认知功能障碍的发生率较高，以短时记忆、语言最易受损；高龄、高发病年龄、运动障碍严重、抑郁状态的PD患者认知功能易受影响。

Outcome analysis of cognitive function assessment scales in Guangzhou patients with Parkinson's disease

Objective： To investigate the clinical characteristics and correlative factors of cognitive impairment in Guangzhou patients with Parkinson＇ s disease （PD）. Methods： A questionnaire survey was conducted among 107 PD patients registered to 6 hospitals in Guangzhou. Montreal Cognitive Assessment （MoCA） was used to evaluate the cognitive impairment in these patients. The clinical phenotypes of PD were assessed by Unified Parkinson＇s Disease Rating Scale（ UPDRS Ⅱ-Ⅳ ）, Hamihon Depression Scale （HRSD） and Hoehn-Yahr staging （H-Y）. The relationship between the cognitive impairment and its correlative factor were analyzed by Spearman correlation analysis. Results：The incidence of cognitive impairment was 83.2% in PD patients. Among them, the cognitive domains of short-term memory, language were most frequently affected, followed by impaired visuospatial/executive capacities, attention, and abstract thinking which were found in over 50% of the patients. The education years were positively correlated with MoCA score （ rs = 0.542, P 〈 0.05 ）, and negatively correlated with patient age, age at onset, UPDRS Ⅱ-Ⅳ score, H-Y staging and HRSD score （rs = -0. 257, -0. 266, -0. 472, -0. 381, -0. 357, all P 〈 0.05）. There was no correlation between MoCA score and duration or onset pattern of PD. The mean MoCA score was significantly different between PD patients on and not on dopamine agonists （ P 〈 0.05 ）. Conclusion： Cognitive impairment is a relatively common complication of PD in Guangzhou, which most frequently involves short-term memory and language capacities. PD patients with advanced or high-risk age, severe movement disorders and depression may be more vulnerable to cognitive function impairment.