多系统萎缩患者认知功能障碍的临床特点及相关因素研究

发布时间：2018-05-17 12:30

本文选题：多系统萎缩 + 认知障碍　；参考：《中国全科医学》2014年14期

【摘要】：目的探讨多系统萎缩(MSA)患者认知功能障碍的临床特点及相关因素。方法选择2012年12月—2013年11月在中国人民解放军总医院神经内科门诊就诊或住院的MSA患者34例,其中小脑性共济失调为主型(MSA-C)患者21例(MSA-C组),帕金森综合征为主型(MSA-P)患者13例(MSA-P组);另选择性别、年龄、受教育程度与MSA患者匹配,生活环境与之相似的健康老年人18例为对照组。对3组受试者进行整体认知评估、执行功能评估、肛门括约肌肌电图检查。结果 MSA-P组年龄大于MSA-C组和对照组,受教育年限长于MSA-C组和对照组(P0.05)。MSA-C组蒙特利尔认知评估量表(MoCA)得分低于对照组(P0.05)。MSA-C组、MSA-P组Stroop测验卡片A、B、D耗时长于对照组,MSA-C组卡片C耗时长于对照组(P0.05)。MSA-P组画钟试验得分少于对照组(P0.05)。MSA-C组、MSA-P组图形-符号转换/数字-符号转换个数少于对照组(P0.05)。MSA-P组连线测验完成时间长于对照组(P0.05)。MSA-C组、MSA-P组语义流畅性得分均少于对照组,MSA-C组语义流畅性得分小于MSA-P组(P0.05)。根据肛门括约肌肌电图检查结果,将MSA患者分为肌电图正常组19例,肌电图异常组15例,肌电图异常组Stroop测验卡片D耗时、连线测验完成时间长于肌电图正常组,画钟试验得分低于肌电图正常组(P0.05)。多元线性回归分析结果显示,语义流畅性得分与受教育年限呈负相关(r=-0.443,P0.05);连线测验完成时间与年龄呈正相关(r=0.462,P0.01);肌电图异常率与画钟试验得分呈负相关(r=-0.411,P0.05),与连线测验完成时间、Stroop测验卡片D耗时均呈正相关(r=0.473、0.455,P0.05)。结论 MSA患者可出现认知功能障碍,尤其是执行功能障碍,肛门括约肌肌电图异常(神经源性损伤)患者认知功能障碍程度较重。
[Abstract]:Objective to investigate the clinical features and related factors of cognitive dysfunction in patients with multiple system atrophy (MSA). Methods from December 2012 to November 2013, 34 patients with MSA were enrolled in the Department of Neurology, General Hospital of the Chinese people's Liberation Army (PLA). Among them, 21 patients with cerebellar ataxia (MSA-CC) and 13 patients with Parkinson's syndrome (MSA-P) were treated with MSA-C and MSA-P respectively. 18 healthy elderly people with similar living environment served as control group. Three groups of subjects were assessed with global cognition, functional evaluation and anal sphincter electromyography. Results the age of MSA-P group was larger than that of MSA-C group and control group. The score of Montreal Cognitive Assessment scale (MSA-C) in MSA-C group was longer than that in MSA-C group and control group (P 0.05). The score of MSA-C group was lower than that of MSA-P group (P 0.05). MSA-C group took longer time than control group (P 0.05. MSA-P group) to draw clock test score of MSA-P group. MSA-C group took longer time than control group (P 0.05). MSA-C group (P < 0.05). MSA-C group (P < 0.05) and MSA-C group (P < 0.05). The number of graph-symbol conversion / digital-symbol conversion in MSA-P group was less than that in control group P0.05U. MSA-P group. The completion time of MSA-P group was longer than that of control group P0.05U. MSA-C group. The semantic fluency score of MSA-C group was lower than that of MSA-C group, and the semantic fluency score of MSA-C group was lower than that of MSA-P group. According to the results of anal sphincter electromyography (EMG), the patients with MSA were divided into normal EMG group (n = 19) and abnormal EMG group (n = 15). The Stroop test card D of abnormal EMG group was time-consuming, and the completion time of wired test was longer than that of normal EMG group. The score of clock drawing test was lower than that of normal EMG group (P 0.05). The results of multiple linear regression analysis showed that, There was a negative correlation between the score of semantic fluency and the years of education, the time of completion of the wired test and the age; the abnormal rate of EMG was negatively correlated with the score of the bell drawing test; and the completion time of the Stroop test card D was positively correlated with the time of completion of the test and the time taken by the Stroop test card. Conclusion Cognitive dysfunction may occur in patients with MSA, especially in patients with executive dysfunction. The degree of cognitive dysfunction in patients with abnormal anal sphincter electromyography (neurogenic injury) is serious.
【作者单位】：中国人民解放军总医院神经内科;
【分类号】：R749.1

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