帕金森病患者视空间障碍及其相关因素的分析

目的 探讨帕金森病(PD)患者视空间障碍情况及其与相关因素的关系. 方法 选择自2007年4月至6月在广州6家医院门诊或住院部连续就诊并且同意参与本次调查的PD患者共107例,用复制立方体评估PD患者的视空间能力,并选用Hoehn-Yahr分级、PD统一评分量表第2部分(UPDRS-Ⅱ)、UPDRS-Ⅲ、UPDRS-Ⅴ、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HRSD)、Fuld物体记忆测验(FOM)、言语流畅性测验(RVR)、韦氏成人智力量表积木测验(WAIS-BD)、韦氏成人量表数字广度测验(WAIS-DS)、简易精神状态量表(MMSE)、神经精神科问卷(NPI)、睡眠量表、Epworth嗜睡量表(ESS)、非运动并发症等量表评估PD患者的运动症状、神经精神症状、认知及日常生活能力.用Spearman相关分析分析视空间能力与各相关因素的双变量相关性,用二分类Logistic回归分析视空间障碍与相关因素的关系. 结果 在107例PD患者中有59例(55.14%)出现视空间损害.Spearman相关分析表明,视空间能力与发病年龄、性别、Hoehn-Yahr分级、病程、UPDRS-Ⅱ、UPDRS-Ⅲ、FOM、RVR、WISC-BD、WAIS-DS、焦虑状态、痴呆等相关(P＜0.05).经二分类Logistic回归分析发现.Hoehn-Yahr分级及病程是视空间障碍的危险因素,而RVR及WISC-BD是视空间障碍的保护因素. 结论 PD患者视空间障碍的发生可能与病情分级、病程、语言流畅性、图像识别及构造能力等有关,临床上可以通过改善患者运动症状及训练患者的语言能力、图像识别及构造能力等综合治疗来改善患者的视空间能力.

Visuospatial impairment in patients with Parkinson's disease and its related factors

Objective To study the incidence of visuospatial impairment in patients with Parkinson's disease(PD)and its related factors.Methods Visuospatial impairment was assessed in 107 PD patients from 6 hospitals in Guangzhou during the period from April to June 2007 using cube copying test.The motor,neuropsyehiatric,and cognitive symptoms and the activities of daily life(ADL)of the patients were evaluated using Hoehn-Yahr scale,Unified Parkinson's Disease Rating Score-Ⅱ (UPDRS-Ⅱ),UPDRS-Ⅲ,UPDRS-Ⅳ,Hamilton Anxiety Scale(HAMA),Hamilton Rating Scale of Depression(HRSD),Fuld Object-Memory Evaluation(FONt),Rapid Verbal Retrieval Test(RVR),Wechsler Adult Intelligence Scale Block Design(WISC-BD),Wechsler Adult Intelligence Scale Digid Span(WAIS-DS),Mini-Mental State Examination(MMSE),and Neuropsychiatric Inventory(NPI).Spearman correlation analysis was performed to analyze the bivariate correlation between the visual-spatial ability and the related factors,and binary logistic regression analysis was used to identify the factors related to visual-spatial disorder.Results Visuospatial impairment was found in 59 of the 107 patients(55.14%).Logistic regression analysis identified the Hoehn-Yahr stage and duration after disease onset as the risk factors,while RVR and WISCoBD as the protective factors for visuospatial impairment.Conclusion The Hoehn-Yahr stage,duration from disease onset,speech fluency,and image recognition and construction ability are related to visuospatial impairment in the PD patients.The visuospatial ability of the PD patients can be improved by relieving their motor symptoms and trainings for speech and image recognition and construction abilities.