帕金森病痴呆与阿尔茨海默病的认知和精神行为症状比较  

Comparison of cognitive functions and neuropsychiatric symptoms between patients with Parkinson＇s disease dementia and Alzheimer＇s disease

作　　者：唐毅[1] 纪笑娟[1] 邢怡[1] 左秀美[1] 周爱红[1] 贾建平[1] 

机构地区：[1]100053北京,首都医科大学宣武医院神经内科

出　　处：《中华医学杂志》2013年第31期2459-2462,共4页National Medical Journal of China

基　　金：国家重点基础研究发展计划（973计划）（2011CB504104）

摘　　要：目的 比较帕金森病痴呆（PDD）和阿尔茨海默病（AD）患者认知功能损害和精神行为症状的特征.方法 本研究为前瞻性病例对照研究,选取2009年7月至2011年7月在宣武医院记忆门诊和运动障碍门诊就诊的AD（59例）和PDD（52例）患者,按照临床痴呆评分量表（CDR）分为轻度痴呆组和中重度痴呆组.应用世界卫生组织-加利福尼亚洛杉矶大学听觉词语学习测验（WHO-UCLA AVLT）、画钟测验（CDT）、神经精神问卷（NPI）等量表对同等痴呆程度的AD和PDD患者的认知功能和精神行为症状等方面进行评估.采用独立样本t检验,多变量变异数分析、x2检验、Mann-WhitneyU检验等方法进行统计学分析.结果 AD与PDD患者即刻记忆、长时记忆以及再认三方面得分差异无统计学意义（P＞0.05）；两组PDD患者CDT得分均较AD患者显著偏低（轻度组：P＜0.001,中重度组：P=0.027）；超过70％的PDD患者出现至少一项精神行为症状,其中轻度痴呆组PDD患者精神行为症状的出现频率[71.40％ （25/35）]及NPI得分[（8.4±9.8）分]均高于AD患者[频率43.2％ （16/37）,得分（5.7±11.9）分]（P =0.016,0.019）.结论 PDD患者在视空间能力、执行功能等方面的损害重于AD患者.轻度痴呆组中,PDD患者精神行为异常较AD患者更为突出.Objective To compare the cognitive functions and neuropsychiatric symptoms of Parkinson＇s disease dementia （PDD） versus Alzheimer＇s disease （AD）. Methods Patients fulfilling the diagnostic and statistical manual of mental disorders, 4th edition （ DSM-IV ） dementia diagnosis criteria were recruited into this case-control study. AD patients were diagnosed with the criteria of National Institute of Neurologic and Communicative Disorders and Stroke and Alzheimer＇s Disease and Related Disorders Association （NINCDS-ADRDA） while PDD was based upon the standards of Movement Disorder Society （MDS） Task Force. According to clinical dementia rating （CDR） score, they were divided into mild dementia （CDR score = 0. 5/1 ） and moderate-to-severe dementia groups （CDR score = 2/3 ）. World Health Organization-University of California, Los Angeles, auditory verbal learning test （ WHO-UCLA AVLT） , clock drawing test （CDT） and neuropsyehiatric inventory （NP1） were performed. Results No significant difference in immediate memory, delayed memory or long-delayed recognition score was observed between PDD and AD patients （ P 〉 0. 05 ）. CDT score was significantly lower in PDD patients （ mild dementia group ： 0. 9 ± 0. 9 ; moderate-to-severe dementia group ： 0. 6 ± 0. 9） than that of AD patients （ mild dementia group： 1.5 ±0.7, P 〈0.001; moderate-to-severe dementia group： 1.1 ±0.6, P =0.027） and this difference was more significant in mild dementia group. More than 70% of PDD patients reported at least one neuropsychiatric symptom. And also, in mild dementia group, compared with AD patients （frequency： 43.2% （ 16/37 ） , NPI score = 5.7 ± 11.9 ）, a higher frequency of neuropsychiatric symptoms and higher NPI scores were observed in PDD patients （ frequency： 71.40% （ 25/35 ） , NPI score = 8.4± 9. 8 ）. Conclusion More severe impairment in visuospatial ability and executive function was present in PDD And neuropsychiatric symptoms were more com

关 键 词：阿尔茨海默病 帕金森病痴呆 神经心理学 精神行为症状 病例对照研究 

分 类 号：R749.1[医药卫生—神经病学与精神病学]