中文摘要：

目的 探讨早期进行性核上性麻痹（PSP）与帕金森病的一般临床特征和认知功能特点的异同.方法 收集2010年1月至2014年2月在广东省人民医院神经内科门诊及住院部就诊的早期PSP和帕金森病患者中Hoehn-Yahr分级（H＆Y分级）≤3级者共53例（其中PSP 22例,帕金森病31例）进行研究.收集所有入组患者的临床资料（H＆Y分级、日常生活活动能力量表等）,并采用MMSE、蒙特利尔认知评估（MoCA）量表、韦氏智力及记忆力量表等对患者进行神经心理评估,分析早期PSP和帕金森病的一般临床特征、总体认知功能及各分项认知功能的特点.结果 PSP组的日常生活活动能力量表评分（分）和H＆Y分级（级）显著高于帕金森病组（分别为24.53±10.67和16.57±3.97,2.71±0.47和1.92±1.01,t=-3.033、-3.874,均P＜0.05）.整体认知功能评估中PSP组的MMSE、MoCA得分（分）均显著低于帕金森病组（分别为24.95±3.35和27.55±2.08,17.55±4.99和23.29±4.50,t=-3.480、-4.374,均P＜0.05）,MoCA分项测试结果显示,PSP组在视空间与执行功能、命名、注意力和定向的评分（分）均显著低于帕金森病组（分别为1.91±1.67和3.26±1.81,2.36±0.79和2.81±0.48,4.27±1.24和5.39±0.84,4.73±1.32和5.58±0.72,Z=-2.769、-2.399、-3.654、-2.504,均P＜0.05）.韦氏智力及记忆力分量表测试结果发现,PSP组的相似性、图形排列、积木测试和数字广度评分（分）均低于帕金森病组（分别为6.45±2.89和9.97±3.53,5.86±2.03和9.42±2.09,4.91±1.97和8.23±2.81,6.50±2.30和9.42±2.09,Z=-3.488、-3.885、-4.138、-2.180,均P＜0.05）.结论 早期PSP的日常生活能力及病情严重程度下降较帕金森病快;其认知功能损害程度亦较帕金森病重,主要表现在视空间、注意力及执行功能方面.

英文摘要：

Objective To explore the differences of clinical and cognitive characteristics in patients with early progressive supranuclear palsy （PSP） and Parkinson＇s disease （PD）.Methods A total of 53 outpatients and inpatients whose Hoehn-Yahr （H＆Y） stage was ≤3 were recruited （PSP 22,PD 31） from Guangdong General Hospital between January 2010 and February 2014.All participants underwent a detailed series of clinical investigations （such as H＆Y Scale,Activity of Daily Living Scale） and cognitive assessments including Minimum Mental State Examination （MMSE）,Montreal Cognitive Assessment （MoCA）,Wechsler Intelligence Scale and Wechsler Memory Scale neuropsychology tests.Then the differences of clinical and cognitive characteristics were analyzed in early PSP and PD groups.Results The scores of Activity of Daily Living Scale and H＆Y Scale in PSP group were significantly higher than PD group （24.53 ±10.67 vs 16.57 ±3.97,2.71 ±0.47 vs 1.92 ± 1.01,t =-3.033,-3.874,both P ＜0.05）.Global cognitive assessment：MMSE and MoCA scores of PSP patients were obviously lower than PD group （24.95 ± 3.35 vs 27.55 ± 2.08,17.55 ± 4.99 vs 23.29 ± 4.50,t =-3.480,-4.374,both P ＜ 0.05）.MoCA scores in visuospatial and executive function,naming,attention and orientation of PSP group were lower than PD group （1.91 ±1.67 vs3.26±1.81,2.36±0.79vs2.81 ±0.48,4.27±1.24vs5.39± 0.84,4.73 ± 1.32 vs 5.58 ± 0.72,Z =-2.769,-2.399,-3.654,-2.504,all P ＜ 0.05）.These PSP patients also scored less than PD patients on similarities,graphic arrangement,the block design test and digit span （6.45 ±2.89 vs 9.97 ±3.53,5.86±2.03 vs 9.42 ±2.09,4.91 ± 1.97 vs 8.23 ±2.81,6.50± 2.30vs9.42 ±2.09,Z=-3.488,-3.885,-4.138,-2.180,all P＜0.05）.Conclusions The ability of daily life and stage of illness in early PSP patients are worse than PD patients.The cognitive impairments are more serious in PSP group than PD group,mainly in the aspects of visuospatial,attention and executive function.