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目的探讨焦虑对帕金森病(Parkinson’s disease,PD)患者运动功能和认知功能的影响。方法 60例PD患者,采用汉密尔顿焦虑量表14项版本(Hamilton Anxiety Scale-14,HAMA14)评测患者焦虑情绪、简易智能精神状态检查量表(Mini-Mental State Examination,MMSE)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评定患者认知功能、统一帕金森病评定量表第三部分(Unified Parkinson’s Disease Rating Scale PartⅢ,UPDRSⅢ)和Hoehn-Yahr分期评测患者运动功能和病情严重程度。分析焦虑对PD患者运动功能和认知功能的影响。结果 60例患者中,27例(45%)存在焦虑,焦虑与非焦虑组之间的UPDRSⅢ、MMSE和MoCA评分差异有统计学意义(P<0.05);60例患者中,17例(28.33%)为轻度运动功能障碍,43例(71.67%)为中重度运动功能障碍,二组间病程、HAMA14、Hoehn-Yahr分期之间存在差异(P<0.05),并且焦虑(OR=4.280,OR95%CI=1.081~16.937,P=0.038)和病程(OR=6.717,OR95CI=1.743~25.895,P=0.006)是运动功能障碍加重的危险因素。60例患者中,18例(30%)为认知功能正常,26例(43.33%)为轻度认知功能障碍(mild cognitive impairment,MCI),16例(26.67%)为痴呆,三组之间年龄、UPDRSⅢ、HAMA14差异有统计学意义(P<0.05),并且年龄(OR=4.290,OR95%CI=1.133~16.235,P=0.032)和焦虑(OR=4.274,OR95%CI=1.041~17.555,P=0.044)为认知功能障碍发生的危险因素。结论焦虑对PD患者的运动及认知功能有影响,并且是运动功能障碍加重和认知功能障碍发生的危险因素。
Objective To investigate the effect of anxiety on motor function and cognitive function in patients with Parkinson’s disease (PD). Methods Sixty patients with PD were evaluated with Hamilton Anxiety Scale-14 (HAMA14) for evaluating anxiety, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment The Montreal Cognitive Assessment (MoCA) assessed the patient’s cognitive function, the Unified Parkinson’s Disease Rating Scale Part III (UPDRS III), and the Hoehn-Yahr staging to assess motor function and severity. Analysis of anxiety on PD patients with motor function and cognitive function. Results Among 60 patients, anxiety was found in 27 patients (45%), UPDRS Ⅲ, MMSE and MoCA scores were significantly different between anxiety and non-anxiety groups (P <0.05); among the 60 patients, 17 (28.33% ) Were mild dyskinesia, and 43 cases (71.67%) were moderate and severe dyskinesia. There was a significant difference in the course of HAMA14 and Hoehn-Yahr staging between the two groups (P <0.05) and anxiety (OR = 4.280, OR95 % CI = 1.081 ~ 16.937, P = 0.038) and duration of disease (OR = 6.717, OR95CI = 1.743 ~ 25.895, P = 0.006) were the risk factors of aggravating motor dysfunction. Of the 60 patients, 18 (30%) had normal cognitive function, 26 (43.33%) had mild cognitive impairment (MCI) and 16 (26.67%) had dementia. (OR = 4.290, OR 95% CI = 1.133-16.235, P = 0.032) and anxiety (OR = 4.274, OR 95% CI = 1.041-17.555) were significantly different between the two groups (P> 0.05) , P = 0.044) were the risk factors of cognitive dysfunction. Conclusions Anxiety has an impact on motor and cognitive function in patients with PD and is a risk factor for aggravated motor dysfunction and cognitive impairment.