帕金森病轻度认知障碍的相关因素分析及对生活质量的影响

doi:10.3969/j.issn.1003-9198.2021.04.008

摘要/Abstract

摘要： 目的研究PD病人轻度认知障碍(PD-MCI)的影响因素及对生活质量的影响。方法共纳入127例非痴呆PD病人,依据MoCA评分将病人分为PD认知正常(PD-NC)组及PD-MCI组,比较2组临床特征及生活质量,采用多元Logistic回归分析PD-MCI的相关因素。结果非痴呆PD病人中有45.67%存在PD-MCI。单因素分析显示,2组年龄、发病年龄(早发型、晚发型)、受教育年限、统一帕金森病评定量表第Ⅲ部分(UPDRS-Ⅲ)评分、Hoehn-Yahr分级(H-Y分级)、汉密尔顿焦虑量表(HAMA)评分和血Hcy水平差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,高UPDRS-Ⅲ评分及Hcy水平是PD-MCI的危险因素,而高教育水平是保护因素。此外,PD-MCI组的UPDRS-Ⅱ评分、日常生活能力量表(ADL)评分高于PD-NC组,帕金森病生活质量问卷(PDQL-39)评分低于PD-NC组,差异有统计学意义(P<0.05)。结论 PD病人血Hcy水平越高、运动障碍越严重、受教育水平越低,其患认知障碍的风险就越高。此外,PD-MCI病人比PD-NC病人的生活质量差。

关键词: 帕金森病, 轻度认知障碍, 影响因素, 生活质量

Abstract: Objective To study the influencing factors of Parkinson’s disease (PD) with mild cognitive impairment (MCI) in Chinese population and the impact on quality of life. Methods A total of 127 non-demented PD patients were included. The patients were divided into PD with normal cognitive (PD-NC) group and PD-MCI group according to the Chinese version of Montreal Cognitive Assessment score. Clinical characteristics and quality of life of the two groups were compared and analyzed. Multivariate Logistic regression was used to analyze the relevant factors of PD-MCI. Results PD-MCI was present in 45. 67% of non-demented PD patients. Univariate analysis showed that age, onset age (early onset, late onset), years of education, Unified Parkinson’s Disease Rating Scale (UPDRS)-Ⅲ score, Hoehe-Yehr grade, Hamilton Anxiety Scale score and serum homocysteine levels showed statistically significant differences between the two groups(P <0. 05). Multivariate Logistic regression analysis showed that hight UPDRS-Ⅲ score and serum level of homocysteine were risk factors for PD-MCI, and high education level was a protective factor. UPDRS-Ⅱ score and Activity of Daily Living (ADL) score in PD-MCI group were higher than those in PD-NC group, while the score of Parkinson’s disease quality of life questionnaire-39 (PDQL-39) was lower than that in PD-NC group(P<0. 05). Conclusions The higher serum homocysteine level, the more severe movement disorder, and the lower education level of the PD patients, the higher risk of cognitive impairment. In addition, PD-MCI patients have a worse quality of life than PD-NC patients.

Key words: Parkinson’s disease, mild cognitive impairment, influencing factor, quality of life

中图分类号:

R 749.1

董珍, 洪音, 韦艳秋, 孙胜楠, 胡月, 徐耀, 徐俊. 帕金森病轻度认知障碍的相关因素分析及对生活质量的影响[J]. 实用老年医学, 2021, 35(4): 350-353.

DONG Zhen, HU Yue, HONG Yin, XU Jun, WEI Yan-qiu, SUN Sheng-nan, XU Yao. Risk factors related to mild cognitive impairment in patients with Parkinson’s disease and its impact on quality of life[J]. Practical Geriatrics, 2021, 35(4): 350-353.

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