不同亚型轻度认知功能损害患者的神经心理学特征  

The neuropsychological feature of different mild cognitive impairment subtypes

作　　者：曹丽[1] 姚明 董屹[3] 孙中武[1] 

机构地区：[1]安徽医科大学第一附属医院神经内科, 合肥230022 [2]安徽医科大学第四附属医院神经内科 [3]合肥市第一人民医院滨湖医院急诊科

出　　处：《中华神经科杂志》2012年第2期90-95,共6页Chinese Journal of Neurology

基　　金：国家“973计划”项目子项目资助（2007CB512306）;安徽省自然科学基金资助项目（090413121）;安徽省教育厅自然科学基金重点项目（KJ2011A170）

摘　　要：：目的 探讨不同亚型轻度认知功能损害（MCI）患者的神经心理学特征.方法 采用多种神经心理学量表对28例遗忘型MCI （aMCI）、21例血管型MCI （V-MCI）、21例帕金森病型MCI（PD-MCI）及46名健康老年人进行评定,比较不同亚型MCI的神经心理学特征.结果 （1）与健康对照组比较,各亚型MCI组在总体认知评分及剑桥老年认知检查量表中文版（CAMCOG-C）子项评分差异均有统计学意义.aMCI组在定向、语言表达、近记忆、学习记忆、注意、计算、思维及知觉方面均受损,差异具有统计学意义（t=4.580、5.150、3.053、4.070、5.918、2.121、2.952、3.175,均P＜0.05）；语言理解、远记忆与执行能力相对保留,差异无统计学意义.V-MCI组定向、语言表达、注意与执行功能受损（t=2.974、3.165、4.216、3.197,均P＜0.05）,记忆力、计算、思维及知觉较对照组差异无统计学意义.PD-MCI组在语言表达、近记忆、远记忆、学习记忆、注意及执行功能方面损害均显著,差异具有统计学意义（t=4.433、3.065、3.821、3.447、5.344、0.348,均P＜0.05）.（2）各亚型MCI组间比较：与V-MCI组[（3.52±0.87）分、（12.48±1.83）分]相比,aMCI组[（3.07±0.81）分、（11.07±2.28）分]与PD-MCI组[（3.00 ±0.89）分、（11.33 ±1.91）分]在CAMCOG-C总体评分及其子项中记忆能力包括近记忆、学习记忆降低显著,差异具有统计学意义（aMCI与V-MCI比较t=1.868、2.381,PD-MCI与V-MCI比较t=1.921、1.980；均P＜0.05）.PD-MCI组中,远记忆及执行功能较其他两组显著降低,差异具有统计学意义（与aMCI比较t=2.498、4.257,与V-MCI比较t=1.684、1.492：均P＜0.05）.（3）aMCI组GDS评分较健康对照组显著增高,差异具有统计学意义（t=2.850,P＜0.05）,而V-MCI组及PD-MCI组与健康对照组比较差异均无统计学意义,但aMCI组及V-MCI组GDS得分较PD-MCI组增高.结论 3种不同亚型MCI认知损害均为多区域性,aMCI主�Objective To investigate the neuropsychological features of different mild cognitive impairment （MCI） subtypes.Methods A neuropsychology battery was applied in this study.Seventy MCI participants were enrolled in the test and classified as：28 amnestic MCI （ aMCI）,21 vascular MCI （ V-MCI）,and 21 Parkinson＇ s disease MCI （PD-MCI）.Forty six normal old people were also evaluated as control.Results First,there were significant differences in the CAMCOG-C and CAMCOG-C subscales of each MCI subtype compared with the normal control. aMCI patients showed significantly impaired orientation,language expression,recent memory,attention,calculation,abstraction and perception （t =4.580,5.150,3.053,4.070,5.918,2.121,2.952,3.175 ; all P 〈 0.05）.However,the ability of language comprehension,remote memory and execution were relatively reserved.V-MCI patients scored lower in the cognitive function of orientation,language expression,attention and execution compared with the normal control（t =2.974,3.165,4.216,3.197; all P 〈 0.05）,with no significant difference in memory,calculation,abstraction and perception.A boarder cognitive impairment was observed in PD-MCI patients who showed significantly impaired language expression,recent memory,remote memory,learning memory,attention and execution（t =4.433,3.065,3.821,3.447,5.344,0.348 ; all P 〈 0.05）.Second,aMCI （3.07 ± 0.81,11.07 ± 2.28 ） and PD-MCI （3.00 ± 0.89,11.33 ± 1.91 ） patients scored significantly lower in CAMCOG scores and CAMCOG subscales including recent memory and learning memory compared with V-MCI（3.52 ±0.87,12.48 ± 1.83;aMCI vs V-MCI：t =1.868,2.381,PD-MCI vs V-MCI：t =1.921,1.980 ; all P 〈 0.05 ）.The remote memory and execution function in PD-MCI were significantly impaired compared to the other two subtypes（PD-MCI vs aMCI：t =2.498,4.257; PD-MCI vs V-MCI：t =1.684,1.492 ;all P 〈 0.05 ）.Third,the GDS scores were different among the four groups. aMCI grouphad significant higher GDS score compared to the nor

关 键 词：认知障碍 遗忘 痴呆 血管性 帕金森病 神经心理学测验 

分 类 号：R749.16[医药卫生—神经病学与精神病学]