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Neurology:帕金森病患者的痴呆风险预测

2014-10-16 功过不相抵 丁香园

为研究帕金森病患者发生痴呆的早期标志性征象,来自加拿大蒙特利尔麦吉尔大学的Postuma博士科研团队展开了相关研究,研究成果于近日发表在最新一期Neurology杂志上。 本试验纳入80名不伴痴呆的帕金森病患者,全面评估他们的自主神经活动、睡眠、精神状态、视觉、嗅觉和运动情况。跟踪随访4.4年后,对他们进行痴呆相关症状的评估。本研究采用logistic回归法调整了病程长短、随访持续时间、

为研究帕金森病患者发生痴呆的早期标志性征象,来自加拿大蒙特利尔麦吉尔大学的Postuma博士科研团队展开了相关研究,研究成果于近日发表在最新一期Neurology杂志上。

本试验纳入80名不伴痴呆的帕金森病患者,全面评估他们的自主神经活动、睡眠、精神状态、视觉、嗅觉和运动情况。跟踪随访4.4年后,对他们进行痴呆相关症状的评估。本研究采用logistic回归法调整了病程长短、随访持续时间、年龄和性别等混杂因素。

结果显示,这80名患者中,有27位(34%)发展为痴呆,他们多数为年长的、男性患者。轻度认知损害的帕金森病患者发生痴呆的风险相对增高;快速动眼睡眠行为障碍的帕金森病患者发生痴呆的风险显著增高。然而,白天嗜睡或失眠与痴呆发生无关。

高血压的帕金森病患者发生痴呆的风险增高;直立性低血压与痴呆风险强相关;收缩压下降大于10mmHg,痴呆发生风险增加7倍;色觉异常的帕金森病患者发生痴呆的风险增高,嗅觉障碍则与痴呆风险无关。运动变量中,步态异常,摔倒,冻结,手精细运动评定和轮替试验均与痴呆发生风险相关。

本研究得出结论,帕金森病患者的心血管自主神经功能障碍、快速动眼睡眠行为障碍、色觉辨别能力和步态障碍症状可预测痴呆的发生风险。

原始出处:

Anang JB1, Gagnon JF2, Bertrand JA1, Romenets SR1, Latreille V1, Panisset M1, Montplaisir J1, Postuma RB2.Predictors of dementia in Parkinson disease: A prospective cohort study.Neurology. 2014 Sep 30;83(14):1253-60. doi: 10.1212/WNL.0000000000000842. Epub 2014 Aug 29.

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    2015-06-17 yinhl1978
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神经内科医生因工作性质须具备较为娴熟的临床技能。由于诊断工具有限,这些技能在运动障碍疾病的临床实践中尤为重要。1817年James Parkinson描述了这种以他名字命名的疾病的临床特征。1913年,F. Lewy报告了神经包涵体,即著名的路易小体。1919年,Tretiakoff描述了帕金森病(PD)黑质神经元的丢失。路易体性帕金森病,特发性帕金森病和帕金森病这些术语对于临床神经内科医生来说都

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