P300和MoCA量表应用于帕金森患者早期认知功能的临床研究

发布时间：2018-01-19 08:13

  本文关键词： 帕金森病 事件相关电位 P300 蒙特利尔认知评估量表 认知功能障碍　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:帕金森病(Parkinson's disease,PD)是一种神经系统变性疾病,尤其常见于中老年人群,以静止性震颤、肌肉强直、表情呆板、运动迟缓及姿势障碍为主要临床症状。近年来,帕金森病的发病率逐渐呈年轻化趋势,在我国65岁以上人群的发病率超过1%,给社会造成严重的经济负担。帕金森病除了以上典型的运动症状外,其非运动症状往往容易被我们忽视,认知功能障碍是PD最常见的非运动症状之一,而不少PD患者晚期已发展为痴呆,这严重影响患者的生活质量,给其家庭和社会带来沉重的负担。针对PD患者认知功能障碍的早发现和早诊断,采取及时有效的治疗措施,延缓PD痴呆症状,提高患者生活质量,有着重要的临床意义。目前临床上对帕金森病的诊断尚缺乏统一的标准,临床医师对于帕金森病认知功能障碍的诊断方法存在争议。本文通过评估听觉事件相关电位(Event related potential,ERP)-P300和蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)在诊断帕金森病(Parkinson's disease,PD)患者早期认知功能中的作用,试图为临床帕金森病认知功能障碍的诊断提供参考依据。方法:选取年龄和受教育程度等方面差异无统计学意义的40例帕金森(PD组)患者和40例健康老年人群(对照组)。根据帕金森病Hoehn-Yahr分期,将PD组患者分为Ⅰ期PD组,共18例;Ⅱ期PD组,共22例,分别对PD组与正常对照组以及Ⅰ期PD组与Ⅱ期PD组进行ERP-P300电位测定和Mo CA量表评分。采用SPSS17.0统计软件对所有数据进行处理,运用独立样本t检验方法分析比较结果。结果:(1)PD组与正常对照组P300电位测定相比较,PD组潜伏期(346.78±20.38ms)长于对照组潜伏期(320.53±11.50ms),差异有统计学意义(t=7.10,P0.05);PD组波幅(3.93±1.35UV)低于对照组波幅(5.88±1.67UV),差异有统计学意义(t=5.75,P0.05)。两组Mo CA量表评分相比较,其中在Mo CA量表总分、视空间与执行功能得分及记忆测试得分三个项目上,PD组(分别为23.25±0.84分,3.38±0.49分,2.88±0.76分)均低于对照组(分别为24.73±1.48分,4.05±0.7分,3.50±0.72分),差异具有统计学意义(t=-5.47;t=-4.93;t=-3.80,P0.05);其余各项测试差异无统计学意义(P0.05)。(2)I期PD组与Ⅱ期PD组P300电位测定相比,Ⅱ期PD组潜伏期(353.50±14.45ms)长于I期PD组潜伏期(338.56±23.76ms),差异有统计学意义(t=-2.45,P0.05);Ⅱ期PD组波幅(3.28±0.96UV)低于I期PD组波幅(4.45±1.41UV),差异有统计学意义(t=-3.02,P0.05)。两组Mo CA量表评分相比较,其中在Mo CA量表总分、视空间与执行功能得分及记忆测试得分三个项目上,Ⅱ期PD组(分别为23.32±0.78分,3.32±0.48分,2.64±0.80分)均低于I期PD组(分别为24.86±0.49分,3.44±0.51分,3.17±0.62分),差异具有统计学意义(t=-1.58;t=0.81;t=2.32,P0.05);其余各项测试差异无统计学意义(P0.05)。结论:针对PD患者的认知功能障碍,P300和Mo CA量表可以为其早期诊断提供临床依据。
[Abstract]:Objective: Parkinsonian disease (PDD) is a neurodegenerative disease, especially in middle-aged and elderly people, with quiescent tremor and muscular ankylosis. Facial rigidity, motor retardation and postural disorders are the main clinical symptoms. In recent years, the incidence of Parkinson's disease is gradually younger, in China, the incidence of over 65 years of age is more than 1%. In addition to the typical motor symptoms, the non-motor symptoms of Parkinson's disease are often ignored by us. Cognitive dysfunction is one of the most common non-motor symptoms of PD. However, many PD patients have developed into dementia, which seriously affects the quality of life of patients, and brings a heavy burden to their families and society. Early detection and early diagnosis of cognitive dysfunction in PD patients. It has important clinical significance to take timely and effective treatment measures to delay the symptoms of PD dementia and improve the quality of life of the patients. At present, the diagnosis of Parkinson's disease is still lack of a unified standard. There is controversy among clinicians about the diagnostic methods of cognitive dysfunction in Parkinson's disease. This paper evaluates the auditory event-related potential (Event-related potential) and event related potential. ERP)-P300 and Montreal Cognitive Assessment. The role of Mo CA in the diagnosis of early cognitive function in patients with Parkinson's disease (PD). The purpose of this study was to provide a reference for the diagnosis of cognitive dysfunction in Parkinson's disease. Methods: 40 cases of Parkinson's disease with PD were selected with no significant difference in age and education. Patients and 40 healthy elderly people (control group). According to Parkinson's disease Hoehn-Yahr staging. Patients in PD group were divided into stage 鈪，

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