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吴旱淋 汤其强▲.轻度认知障碍患者共情能力和淡漠的变化研究及其与灰质萎缩的相关性分析[J].中国现代医生,2021,59(4):1-4
轻度认知障碍患者共情能力和淡漠的变化研究及其与灰质萎缩的相关性分析
Changes of empathy and apathy in patients with mild cognitive impairment and its correlation with gray matter atrophy
  
DOI:
中文关键词:  轻度认知障碍  共情  淡漠  脑萎缩
英文关键词:Mild cognitive impairment  Empathy  Apathy  Brain atrophy
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作者单位
吴旱淋 汤其强▲ 安徽医科大学附属省立医院神经内科安徽合肥 230001 
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中文摘要:
      目的研究轻度认知障碍患者共情能力与淡漠症状的变化,探索两者的联系及与脑灰质体积的相关性。方法 纳入2019 年7 月至2020 年7 月诊断为MCI 的病例22 例,选择同时期性别、年龄、教育程度无差异的对照组21 例,所有受试者完成神经心理学测评,包括MMSE、MoCA、SDS、IRI(包括PT、FS、EC、PD 四个子项目)、BES(包括认知移情和情感移情)和AES-I 评分,同时测量磁共振的灰质体积,两组结果进行对比并行相关性分析。结果 MCI组的MMSE、MoCA 评分明显低于对照组(P<0.05);MCI组的共情测量评分中IRI 总分及PT、FS 评分显著低于对照组;在移情测评中,MCI组BES 总分低于对照组(P<0.05),主要是情感移情评分;淡漠评定量表-知情者版(AES-I)的测评中,MCI组的评分显著升高(P<0.05);MCI组的T1加权像VBM 测量灰质体积显著小于对照组(P<0.05)。在进一步相关性及回归分析中,Pearson 分析结果示共情能力与淡漠无相关性;IRI 中的PD 评分、淡漠评分与灰质萎缩呈显著负相关(B=-4.098,P=0.032;B=-2.987,P=0.022);而情感移情评分与灰质萎缩呈显著正相关(B=3.623,P=0.013)。结论轻度认知障碍患者共情能力减退,情感移情能力较低,出现淡漠等早期精神行为症状,已有一定的灰质萎缩,且灰质萎缩与患者共情能力减低及淡漠的程度有相关性。
英文摘要:
      Objective To study the changes of empathy and apathy symptoms in patients with mild cognitive impairment(MCI),and to explore the relationship between empathy and apathy symptoms and the correlation between empathy and gray matter volume.Methods A total of 22 cases diagnosed as MCI from July 2019 to July 2020 were enrolled in the study.21 cases with no difference in gender,age and education level in the same period were taken as the control group.All subjects completed neuropsychological assessment,including MMSE,MoCA,SDS,IRI (including PT,FS,EC and PD),BES(including cognitive empathy and emotional empathy) and AES-I scores.At the same time,the gray matter volume of MRI was measured.The results of the two groups were compared and the correlation was analyzed.Results MMSE and MoCA scores in MCI group were significantly lower than those in the control group(P<0.05).The total score of IRI,PT and FS in empathy assessment scale of MCI group were significantly lower than those in the control group(P<0.05).In empathy evaluation,the total score of BES in MCI group was lower than that in the control group (P<0.05),which was mainly emotional empathy score.In apathy evaluation scale-insider version(AES-I),the score of MCI group increased significantly (P<0.05).The gray matter volume measured by VBM on T1weighted images in MCI group was significantly smaller than that in control group(P<0.05).In the further correlation and regression analysis,Pearson analysis showed that there was no correlation between empathy and apathy.PD score and apathy score in IRI were negatively correlated with gray matter atrophy(B=-4.098,P=0.032;B=-2.987,P=0.022).The emotional empathy score was positively correlated with gray matter atrophy(B=3.623,P=0.013).Conclusion MCI patients have a decreased empathy,a low emotional empathy,early mental and behavioral symptoms such as apathy,and gray matter atrophy to some extent,and gray matter atrophy is related to the degree of decreased empathy and apathy.
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