本文關(guān)鍵詞： 帕金森病 事件相關(guān)電位 P300 蒙特利爾認(rèn)知評(píng)估量表 認(rèn)知功能障礙　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:帕金森病(Parkinson's disease,PD)是一種神經(jīng)系統(tǒng)變性疾病,尤其常見于中老年人群,以靜止性震顫、肌肉強(qiáng)直、表情呆板、運(yùn)動(dòng)遲緩及姿勢(shì)障礙為主要臨床癥狀。近年來,帕金森病的發(fā)病率逐漸呈年輕化趨勢(shì),在我國(guó)65歲以上人群的發(fā)病率超過1%,給社會(huì)造成嚴(yán)重的經(jīng)濟(jì)負(fù)擔(dān)。帕金森病除了以上典型的運(yùn)動(dòng)癥狀外,其非運(yùn)動(dòng)癥狀往往容易被我們忽視,認(rèn)知功能障礙是PD最常見的非運(yùn)動(dòng)癥狀之一,而不少PD患者晚期已發(fā)展為癡呆,這嚴(yán)重影響患者的生活質(zhì)量,給其家庭和社會(huì)帶來沉重的負(fù)擔(dān)。針對(duì)PD患者認(rèn)知功能障礙的早發(fā)現(xiàn)和早診斷,采取及時(shí)有效的治療措施,延緩PD癡呆癥狀,提高患者生活質(zhì)量,有著重要的臨床意義。目前臨床上對(duì)帕金森病的診斷尚缺乏統(tǒng)一的標(biāo)準(zhǔn),臨床醫(yī)師對(duì)于帕金森病認(rèn)知功能障礙的診斷方法存在爭(zhēng)議。本文通過評(píng)估聽覺事件相關(guān)電位(Event related potential,ERP)-P300和蒙特利爾認(rèn)知評(píng)估量表(Montreal Cognitive Assessment,Mo CA)在診斷帕金森病(Parkinson's disease,PD)患者早期認(rèn)知功能中的作用,試圖為臨床帕金森病認(rèn)知功能障礙的診斷提供參考依據(jù)。方法:選取年齡和受教育程度等方面差異無(wú)統(tǒng)計(jì)學(xué)意義的40例帕金森(PD組)患者和40例健康老年人群(對(duì)照組)。根據(jù)帕金森病Hoehn-Yahr分期,將PD組患者分為Ⅰ期PD組,共18例;Ⅱ期PD組,共22例,分別對(duì)PD組與正常對(duì)照組以及Ⅰ期PD組與Ⅱ期PD組進(jìn)行ERP-P300電位測(cè)定和Mo CA量表評(píng)分。采用SPSS17.0統(tǒng)計(jì)軟件對(duì)所有數(shù)據(jù)進(jìn)行處理,運(yùn)用獨(dú)立樣本t檢驗(yàn)方法分析比較結(jié)果。結(jié)果:(1)PD組與正常對(duì)照組P300電位測(cè)定相比較,PD組潛伏期(346.78±20.38ms)長(zhǎng)于對(duì)照組潛伏期(320.53±11.50ms),差異有統(tǒng)計(jì)學(xué)意義(t=7.10,P0.05);PD組波幅(3.93±1.35UV)低于對(duì)照組波幅(5.88±1.67UV),差異有統(tǒng)計(jì)學(xué)意義(t=5.75,P0.05)。兩組Mo CA量表評(píng)分相比較,其中在Mo CA量表總分、視空間與執(zhí)行功能得分及記憶測(cè)試得分三個(gè)項(xiàng)目上,PD組(分別為23.25±0.84分,3.38±0.49分,2.88±0.76分)均低于對(duì)照組(分別為24.73±1.48分,4.05±0.7分,3.50±0.72分),差異具有統(tǒng)計(jì)學(xué)意義(t=-5.47;t=-4.93;t=-3.80,P0.05);其余各項(xiàng)測(cè)試差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)I期PD組與Ⅱ期PD組P300電位測(cè)定相比,Ⅱ期PD組潛伏期(353.50±14.45ms)長(zhǎng)于I期PD組潛伏期(338.56±23.76ms),差異有統(tǒng)計(jì)學(xué)意義(t=-2.45,P0.05);Ⅱ期PD組波幅(3.28±0.96UV)低于I期PD組波幅(4.45±1.41UV),差異有統(tǒng)計(jì)學(xué)意義(t=-3.02,P0.05)。兩組Mo CA量表評(píng)分相比較,其中在Mo CA量表總分、視空間與執(zhí)行功能得分及記憶測(cè)試得分三個(gè)項(xiàng)目上,Ⅱ期PD組(分別為23.32±0.78分,3.32±0.48分,2.64±0.80分)均低于I期PD組(分別為24.86±0.49分,3.44±0.51分,3.17±0.62分),差異具有統(tǒng)計(jì)學(xué)意義(t=-1.58;t=0.81;t=2.32,P0.05);其余各項(xiàng)測(cè)試差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:針對(duì)PD患者的認(rèn)知功能障礙,P300和Mo CA量表可以為其早期診斷提供臨床依據(jù)。
[Abstract]:Objective: Parkinsonian disease (PDD) is a neurodegenerative disease, especially in middle-aged and elderly people, with quiescent tremor and muscular ankylosis. Facial rigidity, motor retardation and postural disorders are the main clinical symptoms. In recent years, the incidence of Parkinson's disease is gradually younger, in China, the incidence of over 65 years of age is more than 1%. In addition to the typical motor symptoms, the non-motor symptoms of Parkinson's disease are often ignored by us. Cognitive dysfunction is one of the most common non-motor symptoms of PD. However, many PD patients have developed into dementia, which seriously affects the quality of life of patients, and brings a heavy burden to their families and society. Early detection and early diagnosis of cognitive dysfunction in PD patients. It has important clinical significance to take timely and effective treatment measures to delay the symptoms of PD dementia and improve the quality of life of the patients. At present, the diagnosis of Parkinson's disease is still lack of a unified standard. There is controversy among clinicians about the diagnostic methods of cognitive dysfunction in Parkinson's disease. This paper evaluates the auditory event-related potential (Event-related potential) and event related potential. ERP)-P300 and Montreal Cognitive Assessment. The role of Mo CA in the diagnosis of early cognitive function in patients with Parkinson's disease (PD). The purpose of this study was to provide a reference for the diagnosis of cognitive dysfunction in Parkinson's disease. Methods: 40 cases of Parkinson's disease with PD were selected with no significant difference in age and education. Patients and 40 healthy elderly people (control group). According to Parkinson's disease Hoehn-Yahr staging. Patients in PD group were divided into stage 鈪，

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