LOTCA量表评定帕金森病患者的认知功能

发布时间：2018-02-24 21:43

本文关键词： PD LOTCA 认知障碍　出处：《昆明医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：应用LOTCA量表初步探讨帕金森病患者的认知功能障碍及影响帕金森病患者认知障碍的各相关因素。方法：应用洛文斯顿作业疗法认知评定中文量表(Loewenstein Occupational Therapy Cognitive Assessment Second Edition, LOTCA)(第二版)从定向力、感知觉、视运动组织以及思维操作等方面评估研究对象的认知情况。设置病例组和对照组的纳入和排除标准,选自2011年1月至10月份在昆明医学院第一附属医院神经内科门诊及住院部就诊、新发并诊断为帕金森病的患者,共40例为病例组,以40例无帕金森病的患者、患者家属或陪护人员等健康人群为对照组。按照年龄、教育程度、病程将研究对象分组评估,结果采用SPSS17.0统计软件进行统计学处理。结果：1.两样本均数比较的t检验显示,对照组和病例组在视知觉、空间知觉、视运动组织、思维操作、注意力与专注力5个子项目以及几何图形识别、临摹几何图形、复绘二维图形、插孔拼图、彩色方块拼图、无色方块拼图、碎图复原、画钟面、图片排序、逻辑问题10个次级子项目方面的差异有统计学意义(P0.05)；2.两样本均数比较的t检验及组间方差分析比较显示,不同年龄组别、不同教育程度组别的对照组与病例组间以及不同病程的病例组间,均有一项或两项以上的认知功能方面的差异具有统计学意义(P0.05)。3.在不同的年龄组中,对照组与病例组主要表现为思维操作、视运动组织,注意力与专注力方面的差异具有统计学意义(P0.05)；不同教育程度组中,对照组与病例组主要表现为视知觉、视运动组织、思维操作、注意力与专注力方面的差异具有统计学意义(P0.05)；不同病程中,患者的认知功能障碍主要表现为动作运用、视运动组织方面(P0.05)。4.病例组中,不同教育程度组之间和不同病程组之间差异具有统计学差异.(P0.05),不同年龄组之间差异无明确统计学意义(P0.05)。对照组中,不同教育程度组之间差异具有统计学差异(P0.05),不同年龄组之间差异无明确统计学意义(P0.05)。5.对照组和病例组在视运动组织与思维操作之间存在高度相关关系(r=0.773,P0.001),其余子项目间相关性均较低。结论：1.帕金森病患者认知功能障碍主要表现在视知觉、空间知觉、视运动组织、思维操作、注意力与专注力方面。其中以视运动组织、思维操作、注意力与专注力方面认知受损为主。2.帕金森病患者的认知功能障碍受到受教育程度、病程因素的影响,并且存在着一定规律：文化水平程度越低、病程越长认知损害越明显。反之,教育程度越高、病程越短认知损害相对较轻。但是在本研究统计学结果中,年龄与患者认知障碍之间没有明显关系。3.对照组和病例组中,视运动组织与思维操作之间存在高度相关关系。
[Abstract]:Aim: to investigate the cognitive impairment of Parkinson's disease (PD) patients and the related factors affecting cognitive impairment by using LOTCA scale. Methods: using Loewenstein Occupational Therapy Cognitive Assessment Second Edition, Loewenstein Occupational Cognitive Assessment Second Edition, Loewenstein Therapy Cognitive Assessment Second Edition (second edition), from orientation, perception, perception, and perception, were used. The cognitive status of the subjects was evaluated in terms of exercise organization and mental manipulation, and the inclusion and exclusion criteria of the case group and the control group were set. From January 2011 to October, a total of 40 patients with Parkinson's disease were enrolled in the Department of Neurology, Department of Neurology, first affiliated Hospital of Kunming Medical College. According to the age, education level and course of disease, the subjects were divided into groups and evaluated. The results were analyzed by SPSS17.0 software. Results the t test of comparing the mean of the two samples showed that the control group and the case group had five sub-items of visual perception, spatial perception, visual movement organization, thinking operation, attention and concentration, as well as geometric pattern recognition. Double drawing 2D figure, Jack puzzle, color block puzzle, colorless block puzzle, fragment restoration, clock face, picture sort, The differences in the 10 sub-items of logical question were statistically significant (P 0.05) 2.The t test of the comparison of the mean numbers of the two samples and the analysis of variance among the two groups showed that different age groups, There was one or more cognitive function difference between the control group and the case group with different education level and the case group with different course of disease. There were significant differences in cognitive function among different age groups. The difference between the control group and the case group in the aspects of thinking operation, visual movement organization, attention and concentration was statistically significant (P 0.05), while in the different education level group, the control group and the case group mainly showed visual perception and visual movement tissue. The differences of thinking operation, attention and concentration were statistically significant (P 0.05). In different course of disease, the main manifestations of cognitive dysfunction in patients were movement use, visual movement organization (P 0.05). 4. In the case group, There was statistical difference between different education level groups and different course groups, but there was no significant difference between different age groups (P 0.05). In the control group, there was no significant difference between the two groups. There was statistical difference between different education level groups (P 0.05), but there was no significant difference between different age groups (P 0.05). There was a high correlation between visual motion organization and thinking operation in control group and case group. The correlation between eyes was low. Conclusion 1. Cognitive dysfunction in Parkinson's disease patients is mainly manifested in visual perception, spatial perception, visual motor organization, thinking operation, attention and concentration. Cognitive impairment in patients with Parkinson's disease is affected by educational level and course of disease, and there are certain rules: the lower the level of education, the lower the level of education. The longer the course of disease, the more obvious the cognitive impairment. On the contrary, the higher the education level, the shorter the course of cognitive impairment. However, there was no significant relationship between age and cognitive impairment in this study. 3. In the control group and the case group, there was no significant correlation between age and cognitive impairment. There is a high correlation between visual movement organization and thinking operation.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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