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目的探讨画钟试验(CDT)在筛查帕金森病(PD)认知功能损害中的应用价值。方法共纳入43例PD患者,记录其年龄、病程、受教育年限、运动功能(UPDRS-Ⅲ)和Hoehn&Yah(rH-Y)分级,并进行CDT、汉密尔顿抑郁量表(HAMD)、简易智能精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)等评估。两组均数比较用t检验,相关分析采用Pearson相关系数分析。结果本组PD患者CDT异常率为48.8%,其中轮廓异常3例(7.0%),数字异常15例(34.9%),指针异常17例(39.5%)。CDT正常组和CDT异常组在年龄、病程、受教育年限和UPRDS-III方面的差异均无统计学意义;而在H-Y分级、MMSE和MoCA方面的差异均有显著性(P<0.01)。CDT与MMSE、MoCA呈正相关,相关系数分别为0.660和0.694,P<0.001;与H-Y分级呈负相关,相关系数为-0.534,P<0.001;与年龄、病程、受教育年限和UPRDS-III等因素不相关(P>0.05)。结论 CDT为简便易行敏感的PD认知功能损害的初筛工具。
Objective To investigate the value of drawing clock test (CDT) in screening cognitive impairment of Parkinson’s disease (PD). Methods A total of 43 PD patients were enrolled in this study. Their age, course of disease, years of education, motor function (UPDRS-Ⅲ) and Hoehn & Yah (rH-Y) were recorded. CDT, Hamilton Depression Scale (HAMD) MMSE and Montreal Cognitive Assessment Scale (MoCA). The two groups were compared using t test, correlation analysis using Pearson correlation coefficient analysis. Results The abnormal rate of CDT in PD patients was 48.8%. There were 3 cases (7.0%) with abnormal contour, 15 cases (34.9%) with abnormal figures and 17 cases (39.5%) with abnormal hands. There was no significant difference in the age, course of disease, education duration and UPRDS-III between the normal CDT group and the abnormal CDT group, but there was significant difference between the MMSE and MoCA in the H-Y classification (P <0.01). CDT was positively correlated with MMSE and MoCA, and the correlation coefficients were 0.660 and 0.694, respectively, P <0.001; negatively correlated with HY grade, the correlation coefficient was -0.534, P <0.001; with age, course of disease, years of education and UPRDS-III The factors are not related (P> 0.05). Conclusions CDT is a simple and sensitive tool for screening cognitive impairment of PD.