摘要
目的探讨脑白质病变(WML)与帕金森病(PD)患者认知功能障碍的相关性。方法纳入60岁以上的PD患者412例,收集患者年龄、临床特征和磁共振WML影像学资料,并进行认知功能障碍的神经心理学评估。WML的严重程度按Fazekas视觉模拟评分法分为0~3级。认知功能障碍分为轻度认知功能障碍(MCI)和痴呆。根据PD患者的认知功能状态,分为PD认知功能正常组(PD-NC组,n=329)、帕金森轻度认知功能障碍组(PD-MCI组,n=46)及帕金森痴呆组(PDD,n=37)。探讨PD患者认知功能障碍的危险因素,以及WML严重程度与PD患者认知功能障碍之间的关系。结果在调整了混杂因素后,多因素Logistics回归分析结果显示PD患者的年龄、病程、低教育水平、高血压、糖尿病、高脂血症、UPDRS partⅢ评分及改良H&Y分期数值及WML是PD发生认知功能障碍的危险因素(P<0.05)。同时Logistics回归分析结果显示,WML Fazekas 3级与PD-MCI明显相关(OR=2.52,95%CI:1.83~3.21),同时WML Fazekas 2级及Fazekas 3级均与PDD明显相关(2级,OR=2.27,95%CI:1.58~2.89;3级,OR=2.86,95%CI:1.94~3.87)。结论 WML是PD患者的认知功能障碍一种重要的危险因素,同时WML的严重程度与PD患者的认知功能障碍发生存在明显相关性。
Objective To investigate the correlation between the cerebral white matter lesions（WML）and cognitive impairment in the patients with Parkinson′s disease（PD）.Methods Four hundreds and twelve patients with PD aged more than 60 years old were included in this study.The data of age,clinical characteristics and MRI of WML were collected,and the neuropsychological evaluation of cognition function impairment was performed.The severity of WML was divided into the grade 0-3 according to the Fazekas visual analogue scale.The cognitive function impairment was divided into the mild cognitive impairment（MCI）and dementia.According to the cognitive function status of the PD patients,the cases were divided into the PD with normal cognitive function group（PD-NC group,n=329）,PD with mild cognitive impairment group（PD-MCI group,n=46）and PD dementia group（PDD group,n=37）.The risk factors of cognitive impairment in PD patients and the relationship between the severity of WML and cognitive impairment in the PD patients were investigated.Results After adjusting the confounding factors,the multivariate Logistic regression analysis results showed that the age,disease course,low educational level,hypertension,diabetes,hyperlipidemia,UPDRS partⅢ score,improved HY staging value and WML were the risk factors of cognitive impairment in PD（P〈0.05）.Meanwhile the Logistic regression analysis results indicated that the Fazekas grade 3 of WML was significantly correlated with PD-MCI（OR=2.52,95%CI：1.83-3.21）,meanwhile the Fazekas grade 2 and 3 of WML all were correlated with PDD（grade 2,OR=2.27,95%CI：1.58-2.89;grade 3,OR=2.86,95%CI：1.94-3.87）.Conclusion WML is an important risk factor for cognitive function impairment in PD patients.And the severity of WML has significant correlation with the cognitive function impairment occurrence in PD patients.
作者
彭泽艳
董舒阳
周华东
PENG Zeyan1 , DONG Shuyang1 , ZHOU Huadong2(1. Postgraduate School, Bengbu Medical College, Bengbu,Anhui 233030, China ; 2. Department of Neurology, Institute of Surgery Research, Daping Hospital ,Army Military Medical University, Chongqing 400042, Chin)
出处
《重庆医学》
CAS
2018年第24期3146-3150,共5页
Chongqing medicine
基金
国家自然科学基金资助项目(81571258)
蚌埠医学院研究生科研创新计划项目(Byycx1613)
关键词
帕金森病
脑白质病变
认知功能障碍
Parkinson disease
cerebral white matter lesions
cognitive function impairment
