完全性脊髓损伤患者的情绪及认知行为分析

doi:10.3969/j.issn.1006-9771.2023.05.013

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (5): 576-581.doi: 10.3969/j.issn.1006-9771.2023.05.013

完全性脊髓损伤患者的情绪及认知行为分析

蒋乐¹^,^2a, 杜良杰¹^,^2b(), 黄富表¹^,^2a

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院，a.OT科；b.脊柱脊髓神经功能重建科，北京市 100068

收稿日期:2023-02-03 修回日期:2023-04-13 出版日期:2023-05-25 发布日期:2023-06-19
通讯作者: 杜良杰(1964-)，男，博士，主任医师，主要研究方向：脊髓损伤康复与功能重建、颈椎病康复。E-mail：940142623@qq.com
作者简介:蒋乐(1984-)，女，汉族，北京市人，主管技师，主要研究方向：康复治疗学。
基金资助:
中国康复研究中心重点科研基金项目(2020-01)

Mood states and cognitive performance in patients with complete spinal cord injury

JIANG Le¹^,^2a, DU Liangjie¹^,^2b(), HUANG Fubiao¹^,^2a

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. a.Department of Occupational Therapy; b.Department of Spinal and Neural Functional Reconstruction, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2023-02-03 Revised:2023-04-13 Published:2023-05-25 Online:2023-06-19
Contact: DU Liangjie, E-mail: 940142623@qq.com
Supported by:
China Rehabilitation Research Center Project(2020-01)

摘要/Abstract

摘要：

目的研究完全性脊髓损伤患者的情绪、认知行为及其相关的影响因素。

方法选取2020年11月至2022年3月在北京博爱医院住院的60例男性完全性脊髓损伤患者作为脊髓损伤组，以30例健康男性作为对照组。应用北京版蒙特利尔认知评估量表(MoCA)、韦氏记忆量表的数字广度测验(DST)、符号数字转换测验(SDMT)的口头测试、Rey-Osterrieth复杂图形测验的延迟回忆测试(CFT)、Stroop色词测验中文版(CWT)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)进行评估。

结果与对照组相比，脊髓损伤组SDMT和CFT评分均明显降低(t > 3.052，P < 0.01)；脊髓损伤组的MoCA评分之反向平方根、干扰量耗时之平方根、HAMA和HAMD评分均升高(|t| > 2.542, |Z| > 7.676, P < 0.05)。多元线性回归分析显示，脊髓损伤组年龄、文化程度、HAMD评分和睡眠障碍均与认知功能部分量表评分相关(P < 0.05)。

结论完全性脊髓损伤患者焦虑和抑郁程度高于正常人，存在认知功能障碍，表现在信息处理速度、视觉空间结构感知能力与视觉记忆、执行功能等方面。年龄、文化程度、抑郁和睡眠障碍是完全性脊髓损伤患者出现认知功能障碍的影响因素。

关键词: 完全性脊髓损伤, 情绪, 认知行为, 相关因素

Abstract:

Objective To investigate the mood states, cognitive performance and the factors related to cognitive function of patients with complete spinal cord injury.

Methods A total of 60 male patients with complete spinal cord injury (SCI) admitted to Beijing Bo'ai Hospital from November, 2020 to March, 2022 were selected as SCI group, and 30 healthy males were selected as the control group. They were assessed with Montreal Cognitive Assessment Beijing Version (MoCA), Digital Span Test (DST) of Wechsler Memory Scale, Symbol Digit Modalities Test-Oral Version (SDMT), Rey-Osterrieth Complex Figure Test-30 min recall (CFT), Stroop Color-Word Test Chinese Version (CWT), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).

Results Compared with the control group, the SDMT and CFT scores were significantly lower (t > 3.052，P< 0.01); the reflect and square root transformation of MoCA score, the square root transformation of Stroop interference effects time consuming, HAMA score and HAMD score were higher (|t|> 2.542, |Z|> 7.676, P< 0.05) in SCI group. Multiple linear regression analysis indicated that age, education level, HAMD score and sleep disorder were significantly correlated with the scores of cognitive function in SCI group.

Conclusion There are more intensive anxiety and depression in patients with complete SCI. The patients with complete SCI present cognitive impairment, especially in information processing speed, visuospatial ability and visual memory, and executive function. Age, education level, depression and sleep disorder are the related factors of cognitive impairment in patients with complete SCI.

Key words: complete spinal cord injury, mood, cognitive performance, related factors

中图分类号:

R651.2

蒋乐, 杜良杰, 黄富表. 完全性脊髓损伤患者的情绪及认知行为分析[J]. 《中国康复理论与实践》, 2023, 29(5): 576-581.

JIANG Le, DU Liangjie, HUANG Fubiao. Mood states and cognitive performance in patients with complete spinal cord injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 576-581.

图/表 4

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项目	对照组 (n = 30)	脊髓损伤组(n = 60)	t/χ²值	P值
年龄/岁	41.63±8.46	39.80±9.75	0.877	0.383
文化程度/年	11.77±3.73	11.68±3.72	0.100	0.921
睡眠障碍/n			7.330	0.007
否	23	28
是	7	32

项目	对照组(n = 30)	脊髓损伤组(n = 60)	t/Z值	P值
MoCA评分(反向平方根)	1.81±0.52	2.12±0.55	-2.542	0.013
DST	14.07±2.86	13.15±2.13	1.552	0.128
SDMT	62.43±10.60	54.33±12.44	3.052	0.003
CFT	27.13±5.48	19.38±6.34	5.717	< 0.001
SIE耗时(平方根)	4.05±0.63	4.84±0.79	-4.787	< 0.001
SIE正确数	0.00(0.00, 0.00)	0.00(-1.00, 0.00)	-1.869	0.062
HAMA	7.00(5.75, 9.25)	21.00(16.50, 23.00)	-7.676	< 0.001
HAMD	7.00(5.00， 10.25)	23.00(18.25, 26.00)	-7.700	< 0.001

项目	MoCA(反向平方根)			SDMT			CFT			SIE耗时(平方根)
项目	B值	t值	P值	B值	t值	P值	B值	t值	P值	B值	t值	P值
年龄^a	0.021	3.110	0.003	-0.573	-3.828	< 0.001	-0.185	-2.264	0.027	0.035	3.626	0.001
文化程度^a	-0.054	-2.966	0.004	1.328	3.299	0.002	0.533	2.514	0.015	-0.085	-3.331	0.002
病程分期^b	-	0.766	0.447	-	-0.329	0.743	-	0.700	0.487	-	1.145	0.257
损伤节段^b	-	0.500	0.619	-	-0.780	0.439	-	-1.177	0.244	-	0.774	0.442
HAMA^a	0.026	1.352	0.182	-0.311	-0.711	0.480	0.055	0.243	0.809	0.046	1.708	0.093
HAMD^a	0.047	3.504	0.001	-0.854	-2.734	0.008	-0.189	-1.132	0.262	0.051	2.571	0.013
睡眠障碍^b	-	-2.120	0.038	-	2.982	0.004	-	3.078	0.003	-	-3.934	< 0.001
药物^b	-	0.152	0.880	-	-0.295	0.769	-	-0.484	0.630	-	-1.212	0.230
神经痛^b	-	-0.306	0.761	-	0.497	0.621	-	0.015	0.988	-	-0.502	0.617

项目	MoCA(反向平方根)			SDMT			CFT			SIE耗时(平方根)
项目	B值	t值	P值	B值	t值	P值	B值	t值	P值	B值	t值	P值
年龄	0.014	2.190	0.033	-0.410	-2.945	0.005	-0.121	-1.537	0.130	0.024	2.794	0.007
文化程度	-0.039	-2.340	0.023	0.981	2.723	0.009	0.443	2.175	0.034	-0.064	-2.935	0.005
HAMD	0.034	2.484	0.016	-0.363	-1.236	0.222	0.087	0.523	0.603	0.012	0.696	0.490
睡眠障碍	0.104	0.782	0.438	-6.033	-2.119	0.039	-4.562	-2.837	0.006	0.576	3.327	0.002

完全性脊髓损伤患者的情绪及认知行为分析

Mood states and cognitive performance in patients with complete spinal cord injury

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