老年性谵妄临床特征及相关因素分析  

Analysis of the clinical features and risk factors of delirium in elderly patients.

作　　者：任艳萍[1] 蔡焯基[1] 马辛[1] 贺佳丽[1] 董培文[2] 

机构地区：[1]首都医科大学附属北京安定医院,100088 [2]北京宣武医院

出　　处：《中国神经精神疾病杂志》2000年第5期268-271,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的　以谵妄量表 (DSS)为工具测评老年性谵妄临床特征 ,并从社会、心理、生物学角度分析老年性谵妄发生的相关因素。方法　对研究期间的住院患者进行前瞻性观察 ,选择谵妄患者 ,收集其临床资料 ,并与对照组相对照。结果　共完成 82例 ,其中谵妄病人 41例 ,对照组 41例。谵妄的症状主要是注意力障碍 ,思维障碍 ,意识障碍 ,定向力障碍 ,睡眠 觉醒周期障碍 (DSS评分分别为 0 2± 0 5 ,0 2± 0 5 ,0 3± 0 5 ,0 3± 0 6,0 3± 0 8)等。谵妄组患者氧分压、血氧饱和度均低于对照组患者 (P <0 0 5 )。内向性格 ,人际关系紧张 ,生活事件刺激 ,男性 ,急性起病 ,白蛋白降低 ,肌酐、尿素氮水平增高 ,肺部感染 ,颅脑CT异常与谵妄发生有关。结论　年龄大、急性起病、躯体疾病、脑部器质性病变、应激与谵妄发生有关。氧分压与血氧饱和度降低是预示谵妄的敏感指标。Objective To determine the clinical fectures and risk factors of delirium in elderly inpatients with delirium. Methods A prospective study was conducted. Patients over 60 years old were selected in the light of diagnostis criteria for delirium in DSM Ⅳ or CCMD Ⅱ R. Biological information, demographic and psychological data (54 marks) were collected. Logistic regression was used to process the data.Results The symptom of delirium was alteration of attention, incoherent thought process, abnormalities of orientation, clouding of consciousness, and disturbance of the sleep wake cycle(the score of DSS is 0.2±0.5, 0.2±0.5, 0.3±0.5, 0.3±0.6, 0.3±0.8, respectively). The PO 2 and O 2SAT were significantly lower in delirious patients than in controls ( P<0.05 ). The onset of delirium was related to introverted personality, poor interpersonal relationship, life events, male, acute onset, decrease of albumin level, increase of Cr, BUN, infection, abniormal cerebral CT scan. Conclusions Elder patients are vulnerable to be delirious. ove life event and physical disease play an important role. Decrease of PO 2, O 2SAT were closely related to delirium.

关 键 词：老年性谵妄 临床特征 危险因素 相关因素分析 

分 类 号：R749.1[医药卫生—神经病学与精神病学]