遗忘型轻度认知损害患者和非痴呆血管性认知的损害患者认知功能比较  

Comparison of Cognitive Functions in Patients with Amnestic Mild Cognitive Impairment and Vascular Cognitive Impairment-no Dementia

作　　者：袁晶[1] 郭起浩[1] 付建辉[1] 洪震[1] 

机构地区：[1]复旦大学附属华山医院神经内科,上海200040

出　　处：《中国心理卫生杂志》2009年第2期77-82,共6页Chinese Mental Health Journal

基　　金：国家自然科学基金(30570601)

摘　　要：目的:探讨遗忘型轻度认知损害(amnesticmild cognitive impairment,aMCI)和非痴呆血管性认知损害(vascular cognitive impairment-no dementia,VCI-ND)的认知缺损的特征。方法:本研究为病例对照研究。2006年10月至2007年3月在本院神经内科"记忆障碍"或"中风"门诊选取遗忘型轻度认知损害者10人、非痴呆血管性认知损害者12人,在社区退休老人中随机抽取16人为正常对照组。所有受试年龄在50～80岁之间,教育程度在初中及初中以上,全部完成头颅CT或核磁共振、简易精神状态量表(Mini-mental State Examination,MMSE)及成套神经心理测验。结果:三种记忆测验中,aMCI组各项记忆得分均为最低,aMCI组和VCI-ND组各项得分均低于正常对照组[如,复杂图形测验延迟回忆:正常组(18.8±9.5)、aMCI组(5.6±5.6)、VCI-ND组(9.6±7.0),P<0.01]。执行功能测验中,反应耗时数测验VCI-ND组完成时间为最长,其次是aMCI组[如,连线测验B的耗时数:两组得分分别为(266.6±109.9)、(199.2±48.6),P=0.034];而反应正确数测验VCI-ND和aMCI组表现均较正常组差[如,Stroop色词测验卡片C正确数正常组(46.8±2.9)、aMCI组(38.7±11.6)、VCI-ND组(38.3±6.8),P<0.01]。结论:遗忘型轻度认知损害患者以情景记忆损害为较早出现严重的认知损害,而非痴呆血管性认知损害患者以执行功能的定势转移障碍为主。这个结果反映了两者在病理机制上的差异。Objective： To investigate the cognitive impairment features in patients with amnestic mild cognitive impairment （aMCI） and vascular cognitive impairment-no dementia （VCI-ND） . Methods： Sixteen normal elders, 10 patients with aMCI and 12 patients with VCI-ND were recruited. The normal elders were selected from communities in Shanghai, while the aMCI and VCI-ND patients were selected from outpatient clinic. All participants ranged in age of 50 - 80 years, with education level of junior middle school or above, and they completed cranial CT or MR/and a series of neuropsychological tests. Results： In the three memory tests, aMCI group performed worst. The scores of both aMCI and VCI-ND groups were lower than that of the normal elders. For example, the delayed recall scores of the Rey- Osterrich complex figure test in the three groups were （ 18. 8 ± 9. 5 ） （ normal ）, （ 5.6 ± 5. 6 ） （ aMCI ） and （ 9. 6 ± 7. 0） （ VCI-ND） （P 〈0. 01 ） . In executive function, VCI-ND group performed worse in the tests of consuming time than aMCI group. For example, the results of consuming time of TMT-B in the two groups were （ 266. 6 ± 109. 9 ） and （ 199. 2 ± 48. 6 ） （ P = 0. 034 ） . In the tests which evaluated correct numbers, both aMCI and VCI-ND group performed worse than normal group. For example, the correct scores of card C of the Stroop Color Words Test in the three groupwere （46.8±2.9） （normal）, [38.7±11.6） （aMCI） and （38.3±6.8） （VCI-ND） （P〈0. 01） . Conclusion： The predominant impairments inpatients with aMCI are episodic memory deficits, while in patients with VCI-ND are more featured with executive function impairment. The results may reflect the pathology difference between aMCI and VCI-ND.

关 键 词：神经心理学 量表 轻度认知损害 血管性认知损害 执行功能 病例对照研究 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R749.13[医药卫生—临床医学]