發(fā)布時間：2018-01-19 08:13

  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、運動遲緩及姿勢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,在我國65歲以上人群的發(fā)病率超過1%,給社會造成嚴(yán)重的經(jīng)濟(jì)負(fù)擔(dān)。帕金森病除了以上典型的運動癥狀外,其非運動癥狀往往容易被我們忽視,認(rèn)知功能障礙是PD最常見的非運動癥狀之一,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,給其家庭和社會帶來沉重的負(fù)擔(dān)。針對PD患者認(rèn)知功能障礙的早發(fā)現(xiàn)和早診斷,采取及時有效的治療措施,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。目前臨床上對帕金森病的診斷尚缺乏統(tǒng)一的標(biāo)準(zhǔn),臨床醫(yī)師對于帕金森病認(rèn)知功能障礙的診斷方法存在爭議。本文通過評估聽覺事件相關(guān)電位(Event related potential,ERP)-P300和蒙特利爾認(rèn)知評估量表(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統(tǒng)計學(xué)意義的40例帕金森(PD組)患者和40例健康老年人群(對照組)。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PD組與正常對照組以及Ⅰ期PD組與Ⅱ期PD組進(jìn)行ERP-P300電位測定和Mo CA量表評分。采用SPSS17.0統(tǒng)計軟件對所有數(shù)據(jù)進(jìn)行處理,運用獨立樣本t檢驗方法分析比較結(jié)果。結(jié)果:(1)PD組與正常對照組P300電位測定相比較,PD組潛伏期(346.78±20.38ms)長于對照組潛伏期(320.53±11.50ms),差異有統(tǒng)計學(xué)意義(t=7.10,P0.05);PD組波幅(3.93±1.35UV)低于對照組波幅(5.88±1.67UV),差異有統(tǒng)計學(xué)意義(t=5.75,P0.05)。兩組Mo CA量表評分相比較,其中在Mo CA量表總分、視空間與執(zhí)行功能得分及記憶測試得分三個項目上,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)計學(xué)意義(t=-5.47;t=-4.93;t=-3.80,P0.05);其余各項測試差異無統(tǒng)計學(xué)意義(P0.05)。(2)I期PD組與Ⅱ期PD組P300電位測定相比,Ⅱ期PD組潛伏期(353.50±14.45ms)長于I期PD組潛伏期(338.56±23.76ms),差異有統(tǒng)計學(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)計學(xué)意義(t=-3.02,P0.05)。兩組Mo CA量表評分相比較,其中在Mo CA量表總分、視空間與執(zhí)行功能得分及記憶測試得分三個項目上,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)計學(xué)意義(t=-1.58;t=0.81;t=2.32,P0.05);其余各項測試差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:針對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，

本文編號：1443362