多系统萎缩的认知功能障碍特点分析

目的通过对多系统萎缩患者(MSA)进行认知功能评估,明确其是否存在认知功能障碍,并分析两种亚型(MSA-C型和MSA-P型)的认知功能障碍特点,以期为临床诊断提供参考。方法采用简易智能量表(MMSE)、蒙特利尔认知评估量表(Mo CA)和阿尔茨海默病评定量表-认知分量表(ADAS-cog)分别测评23例MSA患者(MSA-C型13例;MSA-P型10例)和25例健康志愿者的认知功能。结果 MSA组MMSE和Mo CA评分均低于对照组,差异有统计学意义(P0.05);ADAS-cog评分高于对照组,差异有统计学意义(P0.05)。在视空间/执行能力、注意力、语言、抽象思维和延迟记忆方面,MSA组的Mo CA评分低于对照组,差异均有统计学意义(P0.05);在记忆、语言和视空间/执行能力方面,MSA组的ADAS-cog评分高于对照组,差异均有统计学意义(P0.05)。MSA-P型Mo CA评分低于MSA-C型,差异有统计学意义(P0.05);MSA-P型ADAS-cog评分高于MSA-C型,差异有统计学意义(P0.05);MSA-P型在抽象思维和延迟记忆两项目的评分低于MSA-C型,差异有统计学意义(P0.05);MSA-P型在记忆和视空间/执行能力方面的评分高于MSA-C型,差异有统计学意义(P0.05)。结论 MSA患者存在一定程度的认知功能障碍;MSA-P型认知损害较MSA-C型更加广泛和严重。

Features of cognitive impairment in multiple system atrophy

Objective To investigate the cognitive function of patients with multiple system atrophy (MSA), the presence or absence of cognitive impairment, and the features of cognitive impairment in two subtypes (MSA-C type and MSA-P type), and to provide a reference for clinical diagnosis.Methods Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) were used to measure the cognitive function of 23 MSA patients (13 with MSA-C type and 10 with MSA-P type) and 25 healthy volunteers.Results Compared with the control group, the MSA group had significantly lower MMSE and MoCA scores and a significantly higher ADAS-cog score (P<0.05). Compared with the control group, the MSA group had significantly lower scores on the subscales of visual space/executive ability, attention, language, abstract thinking, and delayed memory of MoCA (P<0.05), as well as significantly higher scores on the subscales of memory, language, and visual space/executive ability of ADAS-cog (P<0.05). Compared with those with MSA-C type, the patients with MSA-P type had a significantly lower MoCA score, a significantly higher ADAS-cog score, significantly lower scores on the subscales of abstract thinking and delayed memory, and significantly higher scores on the subscales of memory and visual space/executive ability (all P<0.05).Conclusions MSA patients have a certain degree of cognitive impairment, and patients with MSA-P type have more extensive and severer cognitive impairment than those with MSA-C type.