帕金森病患者轻度认知功能障碍评估

目的:探讨蒙特利尔认知评估量表（MoCA）和简易智能状态量表（MMSE）联合测评帕金森病（Parkinson's disease,PD）患者轻度认知功能障碍（MCI）的敏感性及可行性。方法:应用MoCA和MMSE分别测评60例PD患者和30名对照组健康体检者。结果:PD组MoCA和MMSE测评结果和对照组比较差异有统计学意义（P<0.05）；帕金森UPDRS评分轻、中和重度组患者MMSE与MoCA评分均明显低于对照组，且病情分度越严重MMSE、MoCA评分亦越低（P<0.01）；Hoehn-Yahr分级1～5期组MMSE和MoCA评分均明显低于对照组（P<0.01）；而1～5期组间MMSE和MoCA评分差异均有统计学意义（P<0.05～P<0.01），PD组MoCA评分视空间/执行功能、抽象能力和记忆力评分均显著低于对照组（P<0.01）。结论:MoCA和MMSE联合应用可能有利于早发现PD患者的MCI，MoCA在视空间/执行功能、抽象能力和记忆力等局部认知功能缺损敏感性测评优于MMSE，MoCA可能为PD患者MCI的早期发现、防治提供无创性优先筛选依据。

Evaluation of the mild cognitive impairment in Parkinson's disease

Objective: To discuss the sensitivity and feasibility of Montreal Cognitive Assessment(MoCA) and Mini-Mental State Examination(MMSE) in evaluating the mild cognitive impairment(MCI) of patients with Parkinson's disease(PD).Methods: Sixty PD patients and 30 control patients were evaluated using the MoCA and MMSE.Results: The difference of evaluation result of MoCA and MMSE between the PD group and control group was statistically significant(P<0.05).The scores of MoCA and MMSE in patients with light,medium and severe score of UPDRS were significantly lower than those in control group,and the more severe the disease was,the lower the scores of MoCA and MMSE were(P<0.01).The scores of MoCA and MMSE in patients with satge 1 to 5 of Hoehn-Yahr staging were significantly lower than that in control group(P<0.01);and the differences of the scores of MoCA and MMSE in patients with satge 1 to 5 were statistically significant(P<0.01).The MoCA scores of the space/executive function,abstract ability and memory in PD group were significantly lower than those in control group.Conclusions: The application of MoCA combined with MMSE can be beneficial for early finding the MCI in PD patients,and the sensitivity of MoCA in space/executive function,abstract ability and memory are better than that of MMSE.MoCA can provide the basis in early finding and nonivasive screening the PD patients with mild cognitive impairment.