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标题 早期帕金森病患者嗅觉减退与认知功能的相关性研究
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    谢孟桥 周渊澄 黄惠英 胡佳

    

    

    【摘 要】: 目的:探究早期帕金森患者嗅觉减退与认知障碍的相关性。方法:共纳入32例帕金森病患者及22例健康志愿者,采集参与者的一般信息,使用简短精神状态量表(MMSE)及蒙特利尔认知评估量表(MoCA)对参与者进行认知功能的评价,使用康乃狄克化学感觉临床研究中心嗅功能检查法(connecticut chemosensory clinical research center,CCCRC)对参与者的嗅觉功能进行评估,然后对采集的一般信息及量表评分进行SPSS统计分析。结果:PD组的MMSE得分低于对照组,差异有统计学意义(p<0.05);MoCA得分低于对照组,差异无统计学意义(P>0.05);PD组的CCCRC识别分及阈值分均低于对照组,差异有统计学意义(P<0.05);PD组的MoCA与CCCRC阈值呈正相关关系(r=0.45,p<0.05),MoCA与CCCRC识别分、MMSE与CCCRC阈值及识别分无明显相关(P>0.05)。结论:早期帕金森病患者可能同时存在认知及嗅觉功能的损害,且两者严重程度有一定相关性。

    【关键词】:早期帕金森病;嗅觉减退;认知功能

    Abstract: Objective: to investigate the correlation between olfactory and cognitive impairment in early Parkinsons patients (PD).Methods: A total of 32 patients with Parkinsons disease and 22 healthy volunteers were included. Participants ‘general information was collected, and their cognitive function were assessed using the Short Mental State Scale (MMSE) and Montreal Cognitive Assessment Scale (MoCA), participants olfactory function was evaluated using the Connecticut Chemosensory Clinical Research Center (CCCRC), and then all the information and the scores of the scales were statistically analyzed by SPSS.Results: The MMSE score of the PD group was lower than the control group, and the difference was statistically significant (p <0.05); the MoCA score was lower than the control group, and the difference was not statistically significant (P> 0.05); The CCCRC identification score and threshold score of the PD group were lower than those of the control group, and the differences were statistically significant (P <0.05); MoCA and CCCRC threshold of the PD group were positively correlated (r = 0.45, p <0.05), and MoCA and CCCRC score, MMSE and CCCRC threshold and recognition score were not significantly related (P> 0.05).Conclusion: Patients with early Parkinsons disease may have both cognitive and olfactory impairments, and their severity is related.

    Keywords: early Parkinsons disease;olfactory impairments; cognitive impairment

    【中圖分类号】R742.5【文献标识码】A【文章编号】1672-3783(2020)08-24--01

    帕金森病的临床表现包括运动症状与非运动症状,而非运动症状包括了嗅觉障碍、认知障碍、便秘、抑郁等。目前已有研究表明,帕金森病的非运动症状之间存在某些关联,尤其是嗅觉障碍,其出现时间早,并且广泛发生于早期帕金森患者之中[1]。

    嗅觉减退与认知障碍均为帕金森病的非运动症状。本研究拟评估早期帕金森患者嗅觉减退与认知障碍的相关性,从而更加深入的了解早期帕金森病非运动症状之间的联系,为疾病的早发现、早治疗提供依据,以便更好地识别和管理早期帕金森病的认知障碍。

    1 资料及方法:

    1.1 病例收集 收集2018.6-2019.12于乐山市人民医院神经内科住院部就诊的帕金森病患者。纳入标准:(1)符合帕金森病诊断标准;(2)Hoehn&Yahr分级<3级。排除标准:(1)脑血管、脑炎、外伤、多发性硬化、肿瘤、药物等原因导致的帕金森综合征及叠加综合征;(2)可能影响嗅觉的其他精神疾病,例如阿尔茨海默病、精神分裂症、抑郁症等;(3)有鼻腔或鼻窦疾病及其手术病史,2周内有上呼吸道感染;(4)服用可能影响认知功能的抗帕金森药物;(5)不能配合相关检查的对象。另选择同期性别、年龄与PD组相匹配的健康家属作为对照组。

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