主诉健忘和轻度认知损害患者的抑郁状况比较  

Comparative study of depression status in patients with subjective memory complaints and mild cognitive impairment

作　　者：沈树红[1] 郭起浩[2] 王少石[1] 赵倩华[2] 洪震[2] 

机构地区：[1]上海市第一人民医院分院神经内科,200081 [2]复旦大学附属华山医院神经内科

出　　处：《中华医学杂志》2010年第17期1167-1170,共4页National Medical Journal of China

基　　金：国家自然科学基金（30570601）;上海市科委重大项目（07DJ14005）

摘　　要：目的 比较主诉健忘（SMC）和轻度认知损害（MCI）患者抑郁状况,了解主诉健忘本质特征.方法 2008年4月至2009年4月于华山医院记忆障碍门诊就诊者214例,其中SMC76例、单域遗忘型MCI（aMCI-s）74例,多域遗忘型MCI（aMCI-m）64例,采用流调用抑郁自评量表（CESD）、老年抑郁量表（GDS）和一系列神经心理测验进行评估.结果 根据CESD,抑郁症状阳性率为31%,其中SMC组30%、aMCI-s组24%、aMCI-m组39%;根据GDS,抑郁症状阳性率为43%,其中SMC组47%、aMCI-s组30%、aMCI-m组53%.SMC组的阳性率介于aMCI-s组与aMCI-m组之间.反映抑郁严重度的CESD总分与GDS总分,SMC组CESD总分（12±10）、GDS总分（11±6）均介于aMCI-s组（11±8）、（9±5）与aMCI-m组（15±11）、（12±7）之间,与aMCI-s组或aMCI-m组比较差异均无统计学意义（均P＞0.05）.但是,aMCI-s组与aMCI-m组比较,CESD总分与GDS总分差异有统计学意义（P＜0.05）,aMCI-m组比aMCI-s组抑郁程度严重.结论 SMC抑郁的发生率和严重度与aMCI无显著差异,提示抑郁情绪对于SMC可能不是特异的致病原因.Objective To understand the nature of subjective memory complaints through comparative study of depression status of patients with subjective memory complaints and mild cognitive impairment. Methods A total of 214 patients were assessed with the Center for Epidemiologic Studies Depression （CES-D） scale, the Geriatric Depression Scale and some neuropsychological tests. Among them, 76 were of subjective memory complaints （SMC）, 74 amnestic mild cognitive impairment-single domain （aMCI-s） and 64 amnestic mild cognitive impairment-multiple domain （aMCI-m）. Results According to CESD, 31% of the patients had symptoms of depression. The ratios were 30%, 24% and 39% in SMC,aMCI-s and aMCI-m groups respectively. GDS study showed that 43% of the patients had symptoms of depression. The ratios were 47%, 30% and 53% in SMC, aMCI-s and aMCI-m groups respectively. The ratio in SMC group fell between the other two groups. The total score of CESD （ 12 ± 10） or GDS （ 11 ± 6）of the SMC group, reflecting the severity of depression, fell between aMCI-s （CESD：1 1 ± 8, GDS ：9 ± 5 ）and （ CESD： 15 ± 11, GDS： 12 ± 7） groups. There was no significant difference between them in comparison with either aMCI-s or aMCI-m group （ P ＞ 0. 05 ）. But the total score of CESD or GDS was significantly different between aMCI-m and aMCI-s groups （ P ＜ 0. 05 ）. The depression status was worse in aMCI-m group than that in aMCI-s group. Conclusion There is no significant discrepancy in the incidence and severity of depression between SMC and aMCI groups. It indicates that depressive mood is not the specific cause of SMC.

关 键 词：主诉健忘 抑郁 轻度认知损害 

分 类 号：R749.1[医药卫生—神经病学与精神病学]