摘要
目的探讨老年帕金森病患者自主神经功能与认知功能之间的相关性。方法纳入2020年1月至2022年12月南京医科大学附属脑科医院诊断与治疗的130例老年帕金森病患者,采用Hoehn‑Yahr分期进行疾病分期,统一帕金森病评价量表第三部分(UPDRSⅢ)评价运动障碍严重程度,帕金森病预后量表‑自主神经功能部分(SCOPA‑AUT)评价自主神经功能,简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表(MoCA)评价整体认知功能,非运动症状量表(NMSS)评价总体非运动症状严重程度。结果共130例患者据是否伴发阿尔茨海默病分为伴阿尔茨海默病组(82例)和不伴阿尔茨海默病组(48例)。伴阿尔茨海默病组患者Hoehn‑Yahr分期3~5级比例(χ^(2)=5.689,P=0.017),UPDRSⅢ评分(t=21.490,P=0.000),SCOPA‑AUT评分(t=21.330,P=0.000)及其体温调节障碍(χ^(2)=8.512,P=0.004)、泌尿功能障碍(χ^(2)=17.270,P=0.000)、胃肠功能障碍(χ^(2)=24.471,P=0.000)、瞳孔调节障碍(χ^(2)=5.299,P=0.021)、心血管功能障碍(χ^(2)=15.355,P=0.000)比例,以及NMSS评分(t=32.309,P=0.000)均高于不伴阿尔茨海默病组,而MMSE(t=4.730,P=0.000)和MoCA(t=6.840,P=0.000)总评分及其各项分评分(均P=0.000)均低于不伴阿尔茨海默病组。相关分析显示,伴阿尔茨海默病的帕金森病患者SCOPA‑AUT评分与MMSE和MoCA总评分及其各项分评分呈负相关(均P=0.000)。结论伴阿尔茨海默病的老年帕金森病患者自主神经功能障碍较严重,且其自主神经功能与认知功能密切相关。
Objective To analyze relationship between autonomic nervous function and cognitive function in elderly patients with Parkinson's disease(PD).Methods A total of 130 elderly patients with PD admitted to The Affiliated Brain Hospital of Nanjing Medical University from January 2020 to December 2022 were included.Hoehn‑Yahr staging was used to evaluate stage of the disease,Unified Parkinson's Disease Rating ScaleⅢ(UPDRSⅢ)was used to evaluate the severity of motor disorders,Scales for Outcomes in Parkinson's Disease‑Autonomic(SCOPA‑AUT)was used to evaluate autonomic nervous function,Mini‑Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were used to evaluate cognitive function,Non‑Μotor Symptoms Scale(NMSS)was used to evaluate the severity of nonmotor symptoms.Results According to whether the patients were accompanied by Alzheimer's disease(AD),they were divided into a group with AD(n=82)and a group without AD(n=48).The proportion of Hoehn‑Yahr staging 3 to 5(χ^(2)=5.689,P=0.017),UPDRSⅢscore(t=21.490,P=0.000),SCOPA‑AUT score(t=21.330,P=0.000),dysregulation of body temperature(χ^(2)=8.512,P=0.004),urinary dysfunction(χ^(2)=17.270,P=0.000),gastrointestinal dysfunction(χ^(2)=24.471,P=0.000),dysregulation of pupil(χ^(2)=5.299,P=0.021),cardiovascular dysfunction(χ^(2)=15.355,P=0.000)and NMSS score(t=32.309,P=0.000)in the group with AD were higher than those in the group without AD,the MMSE(t=4.730,P=0.000)and MoCA(t=6.840,P=0.000)total scores and subtype scores(P=0.000,for all)in the group with AD were lower than those in the group without AD.Correlation analysis showed that the SCOPA‑AUT score of PD patients with AD was negatively correlated with MMSE and MoCA total scores and subtype scores(P=0.000,for all).Conclusions The autonomic dysfunction of elderly PD patients with AD is more serious,and the autonomic nervous function is closely related to cognitive function.
作者
姬莉
杨宁
刘卫国
牛程麟
JI Li;YANG Ning;LIU Wei‑guo;NIU Cheng‑lin(Department of Critical Care Medicine,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing Brain Hospital,Nanjing 210029,Jiangsu,China;Department of Traditional Chinese Medicine,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing Brain Hospital,Nanjing 210029,Jiangsu,China;Department of Neurology,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing Brain Hospital,Nanjing 210029,Jiangsu,China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2024年第3期171-176,共6页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
江苏省中医药科技发展专项(项目编号:2020ZX17)。
关键词
帕金森病
阿尔茨海默病
自主神经系统
认知障碍
Parkinson disease
Alzheimer disease
Autonomic nervous system
Cognition disorders
作者简介
通讯作者:牛程麟,Email:niucl8411@126.com。
