帕金森病伴很可能快速眼动睡眠行为障碍与认知功能的相关性研究

发布时间：2018-08-12 11:56

【摘要】：目的:探讨帕金森病(PD Parkinson disease)伴很可能快速眼动睡眠行为障碍(RBD rapid eye movement sleep behavior disorder)与认知功能的关系。方法:收集2014年-2017年在吉林大学中日联谊医院就诊的符合2015年国际运动障碍协会(MDS)帕金森病最新诊断标准的PD住院患者及门诊患者44例,并对其进行定期随访。记录他们的年龄、性别、受教育年限等人口统计学资料及运动症状、非运动症状等PD相关临床资料。依据PD-RBD筛查量表RBDQ-HK将44例患者分为PD-RBD组23例和PD-NRBD组21例,所有受试者均采用统一PD评定量表第Ⅲ部分(UPDRS-Ⅲ)对运动症状进行评估;采用Hoehn-Yahr(HY)PD分级法对PD运动症状的严重程度进行评估;采用简易智能精神状态量表(MMSE)、蒙特利尔量表(MOCA)对全面认知功能进行评估;采用数字符号模式测验、数字广度测验对注意进行评估;采用Stroop色词关联测验(CWT)、连线测验(TMT)对执行功能进行评估;采用画钟测验(CDT)30分评分法对视空间功能进行评估;采用词语流畅性测验(VFT)、Boston命名测验对语言进行评估;采用Rey听觉词语学习测验对记忆力进行评估。上述评价工具均由神经内科专业医师完成对入组患者的临床症状、全面认知功能及各领域认知功能进行评估,并运用统计学方法进行比较。结果:PD-RBD组23例,PD-NRBD组21例,两组患者在年龄、性别、受教育年限、运动症状的比较分析中,无显著性差异(P0.05)。在认知功能方面,PD-RBD组患者与PD-NRBD组患者相比,简易智能精神状态量表(MMSE)、蒙特利尔量表(Mo CA)对全面认知进行评估中,有显著性差异(p0.05);数字符号测验(DST)、连线测试A(Trail Making Test-A,TMT-A)-时间、连线测试B(Trail Making Test-B,TMT-B)-时间、Stroop色词关联测验B时间、画钟测验(CDT)、Boston命名测验(BNT)、词语流畅性(水果)得分均有显著差异(p0.05);PD-RBD组与PD-NRBD组在胃肠消化功能、自主神经功能、神经精神类症状、睡眠状况等非运动症状方面也存在显著性差异(p0.05)。结论:PD-RBD患者与PD-NRBD患者相比较,RBD对PD患者全面认知功能有一定影响;对执行功能、视空间功能、语言功能、注意力等认知领域也存在一定程度的影响;同时RBD对PD患者的非运动症状中的胃肠消化功能、自主神经症状、神经精神症状、睡眠障碍等方面也有不同程度的影响。
[Abstract]:Objective: to investigate the relationship between (RBD rapid eye movement sleep behavior disorder) and cognitive function in Parkinson's disease (PD Parkinson disease) with REM behavior disorder. Methods: a total of 44 PD inpatients and outpatients who met the latest diagnostic criteria for (MDS) Parkinson's disease of the International Association of dyskinesia in 2015 were collected from 2014 to 2017 in the Sino-Japanese Friendship Hospital of Jilin University and were followed up regularly. Their age, sex, years of education and other PD related clinical data were recorded. According to PD-RBD screening scale (RBDQ-HK), 44 patients were divided into PD-RBD group (23 cases) and PD-NRBD group (21 cases). The severity of motor symptoms of PD was evaluated by Hoehn-Yahr (HY) PD classification method, the total cognitive function was evaluated by (MMSE), Montreal scale (MOCA), and the digital symbol model test was used. Digital span test was used to evaluate attention, Stroop color word association test (CWT),) was used to evaluate executive function, (TMT) test was used to evaluate executive function, and (CDT) 30 score method was used to evaluate visual spatial function. The word fluency test (VFT) / Boston naming test was used to evaluate language and Rey auditory word learning test was used to evaluate memory. All the evaluation tools were performed by the neurologist to evaluate the clinical symptoms, total cognitive function and cognitive function in each field of the patients, and compared with each other by statistical method. Results there was no significant difference in age, sex, years of education and motor symptoms between the two groups in 23 cases of PD-NRBD group (P 0.05). In terms of cognitive function, compared with PD-NRBD group, the (Mo CA) of (MMSE), Montreal scale had significant difference in the assessment of total cognition (p0.05), (DST), test of digital symbol test (DST), line test) test of A (Trail Making Test-An TMT-A) -time, There were significant differences in the scores of (BNT), word fluency (p0.05) between PD-RBD group and PD-NRBD group in gastrointestinal digestive function, autonomic nervous function, neuropsychiatric symptoms, and between PD-RBD group and PD-NRBD group. There were also significant differences in non-motor symptoms such as sleep status (p0.05). Conclusion compared with PD-NRBD patients, the patients with PD-NRBD have some effects on the overall cognitive function, executive function, visual spatial function, language function, attention and other cognitive fields. At the same time, RBD also had different effects on gastrointestinal digestive function, autonomic nervous symptoms, neuropsychiatric symptoms and sleep disorders in PD patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5;R740

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