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第45卷第3期                           南京医科大学学报(自然科学版)
                  2025年3月                   Journal of Nanjing Medical University(Natural Sciences)     ·389 ·


               ·临床研究·

                颈动脉内膜中层厚度与帕金森病认知功能障碍的相关性研究



                彭利亚 ,徐 耀 ,乔婷婷 ,马灿灿 ,陈兰兰                2*
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                蚌埠医科大学第一附属医院神经内科,安徽 蚌埠                   233004;苏北人民医院神经内科,江苏           扬州 225001
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               [摘   要] 目的:探索颈动脉内膜中层厚度(carotid intima⁃media thickness,CIMT)和颈动脉斑块与帕金森病(Parkinson’s dis⁃
                ease,PD)患者认知障碍的相关性。方法:根据蒙特利尔认知评价量表,将225例PD患者分为3组:认知功能正常(normal cogni⁃
                tive function,NC)组41例、轻度认知功能障碍(mild cognitive impairment,MCI)组76例和痴呆(Parkinson’s disease with dementia,
                PDD)组108例。比较3组患者间临床资料及颈动脉超声等指标的差异,使用多元线性回归分析PD认知障碍的影响因素。结
                果:与NC组比较,MCI和PDD组的教育水平下降(P均< 0.05),Hoehn⁃Yahr分级、统一帕金森病评定量表第三部分(unified Par⁃
                kinson disease rating scale⁃Ⅲ,UPDRS⁃Ⅲ)、汉密尔顿抑郁量表、匹兹堡睡眠质量指数量表、胱抑素C水平、CIMT、颈动脉斑块易
                损性积分上升(P均< 0.05)。回归分析显示教育水平高是PD认知障碍的保护因素(P < 0.001),而CIMT增厚、Hoehn⁃Yahr分级
                高是PD认知障碍的独立危险因素(P=0.002、P=0.001)。结论:颈动脉粥样硬化与PD认知障碍存在相关性。
               [关键词] 帕金森病;认知障碍;颈动脉粥样硬化;颈动脉内膜中层厚度;颈动脉斑块
               [中图分类号] R742.5                   [文献标志码] A                       [文章编号] 1007⁃4368(2025)03⁃389⁃07
                doi:10.7655/NYDXBNSN240636



                Study on the correlation between carotid intima⁃media thickness and cognitive impairment
                in Parkinson’s disease

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                PENG Liya ,XU Yao ,QIAO Tingting ,MA Cancan ,CHEN Lanlan 2*
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                1 Department of Neurology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233004;Department of
                Neurology,Northern Jiangsu People’s Hospital,Yangzhou 225001,China
               [Abstract] Objective:To investigate whether carotid intima ⁃ media thickness(CIMT)and carotid plaque are associated with
                cognitive impairment in patients with Parkinson’s disease(PD). Methods:According to the Montreal Cognitive Assessment Scale,225
                PD patients were divided into three groups:the normal cognitive function(NC)group(n=41),the mild cognitive impairment(MCI)
                group(n=76),and the Parkinson’s disease with dementia(PDD)group(n=108). Clinical characteristics and carotid ultrasound
                parameters were compared among the groups. Multivariate linear regression analysis was used to identify factors influencing cognitive
                impairment in PD. Results:Compared with the NC group,the MCI and PDD groups showed lower education levels(all P < 0.05)and
                higher Hoehn⁃Yahr(H&Y)stage,unified Parkinon disease rating scale⁃Ⅲ(UPDRS⁃Ⅲ),Hamilton depression scale,Pittsburgh sleep
                quality index scale,cystatin C level,CIMT,carotid plaque detection rate,and carotid plaque vulnerability scores(all P < 0.05).
                Regression analysis showed that high education level was an independent protective factor for PD cognitive impairment(P < 0.001),
                while CIMT thickness(P=0.002)and high H&Y(P=0.001)stage were independent risk factors for PD cognitive impairment.
                Conclusion:Carotid atherosclerosis is associated with cognitive impairment in PD patients.
               [Key words] Parkinson’s disease;cognitive impairment;carotid atherosclerosis;carotid intima⁃media thickness;carotid plaque
                                                                              [J Nanjing Med Univ,2025,45(03):389⁃395]









               [基金项目] 扬州市科技技术项目(YZ2022203)
                通信作者(Corresponding author),E⁃mail:cllin82@sina.com(ORCID:0000⁃0002⁃4563⁃6382)
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