帕金森病患者执行功能障碍与脑小血管病总负荷的相关性研究

doi:10.20223/j.cnki.1000-8535.2025.08.017

摘要/Abstract

摘要： 目的探讨帕金森病（PD）患者执行功能障碍与脑小血管病（CSVD）总负荷的关系。方法回顾性分析2020年1月1日—2024年6月30日在佛山市第一人民医院住院的156例PD患者收集患者的临床资料,包括性别、年龄、教育年限、高血压病史等,采用简易精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）评估认知功能以及采用额叶功能评定表（FAB）评估执行功能。根据患者的认知功能和执行功能评定结果,将156例患者分为PD认知功能正常（PD-NC）组、PD执行功能异常组（PD-EF）和PD非执行功能异常组（PD-NEF）。所有研究对象均行头颅磁共振检查,行CSVD总负荷的评分。比较3组患者一般临床资料、CSVD及其标志物的差异。结果 PD-EF组的年龄、病程、H-Y分期、脑室周围白质高信号（PVWMH）、皮层下白质高信号（DWMH）、腔隙性脑梗死（LI）、CSVD 总负荷评分高于PD-NEF组、PD-NC组,差异均有统计学意义（均P<0.05）。Spearman相关性分析结果显示,PD患者FAB评分与PWMH评分、DWMH评分、LI数目、CSVD总负荷评分均呈负相关（均P<0.05）。多元线性回归分析显示,PD患者FAB评分越低,DWMH评分、LI数目、CSVD总负荷评分均越高（均P<0.05）。结论 PD患者执行功能障碍和CSVD总负荷相关。

关键词: 帕金森病, 认知功能, 执行功能, 脑小血管病总负荷

Abstract: Objective To explore whether total burden of cerebaral small vessel disease（CSVD）detected with MRI was associated with the executive functions in patients with Parkinson's disease（PD）．Methods In total,156 patients with PD in First People's Hospital of Foshan from January 2020 to June 2024 were retrospectively enrolled．Detailed clinical data were obtained． The clinical data of all the patients such as age,gender,years of education,hypertension history were collected．The Mini-Mental State Examination（MMSE）and the Montreal Cognitive Assessment Scale（MoCA）were used to assess cognitive function,the Frontal Assessment Battery（FAB）was used to assess executive function．According to the function levels,all cases were divided into PD with normal cognition（PD-NC）group,PD with executive function（PD-EF）and PD with non-executive function（PD-NEF）．All the patients underwent brain MRI to determine the presence and burden of CSVD,scoring between 0 and 4．Results The age,course of disease,Hoehn-Yahr staging,the scores of periventricular white matter hyperintensities（PWMH）,the scores of deep subcortical white matter hyperintensities（DWMH）,the numbers of lacunar infarcts（LI）,the CSVD scores were significantly higher in the patients of PD-EF group than PD-NC group and PD-NEF group（P<0.05）．Spearman's correlation analysis showed that FAB scores had a significant correlation with scores of PWMH,the scores of DWMH,the numbers of LI,and the CSVD burden scores（P<0.05）．Multivariable analysis showed that there was a significant negative correlation between FAB scores and the scores of DWMH,the numbers of LI,the CSVD scores．Conclusions The total MRI CSVD burden was associated with the executive functions in patients with PD in this study．

Key words: Parkinson's disease, cognitive impairment, executive functions, total burden of CSVD

段振鹏, 周锋, 王玉凯. 帕金森病患者执行功能障碍与脑小血管病总负荷的相关性研究[J]. 广州医药, 2025, 56(8): 1128-1133.

DUAN Zhenpeng, ZHOU Feng, WANG Yukai. The total burden of CSVD correlates with the executive functions in patients with Parkinson's disease[J]. Guangzhou Medical Journal, 2025, 56(8): 1128-1133.

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