神经内科门诊痴呆的流行病学调查  

Epidemiologic investigation of neurology clinic patients with dementia

作　　者：于大林[1] 吕建为[2] 易刚[2] 陈祥慧[2] 肖军[2] 

机构地区：[1]双流县第二人民医院神经内科,四川省610213 [2]四川省人民医院神经内科

出　　处：《中华临床医师杂志（电子版）》2013年第8期102-105,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的了解神经内科门诊55岁以上患者痴呆的就诊比例及各痴呆亚型的比例,探讨各痴呆亚型的临床特点;了解APOE基因与阿尔茨海默病的相关性。方法选取2009年9月25日到2009年12月25日在四川省人民医院神经内科门诊就诊的患者14286人为研究对象,分别用老年人认知功能减退知情者问卷(IQCODE)、简易精神状态量表(MMSE)、Hachinski缺血指数量表(HIS)、日常生活能力量表(ADL)、神经精神问卷(NPI)、Hamilton抑郁量表、自发的画钟测验(CDT)、临床痴呆评定量表(CDR)量表进行检测,诊断痴呆患者进行抽血检查APOE基因。结果在所有就诊患者中阿尔茨海默病占1.99%;血管性痴呆占0.95%;混合性痴呆占0.47%;额颞叶痴呆占0.19%;其他类型痴呆占0.19%。在所有痴呆患者中阿尔茨海默病占52.5%,血管性痴呆占25%,混合性痴呆占12.5%,额颞叶痴呆占5%,其他类型痴呆占5%。阿尔茨海默病与混合性痴呆在即刻记忆、延迟记忆、长延迟再认的得分明显低于血管性痴呆;在定向力、判断力、计算力、日常生活能力方面的得分情况三者无差异;轻度阿尔茨海默病、混合性痴呆在Hamilton抑郁量表中的得分明显高于中重度阿尔茨海默病及血管性痴呆。中重度阿尔茨海默病及血管性痴呆在神经精神问卷中的得分明显高于轻度阿尔茨海默病及混合性痴呆。在自发的画钟测验方面,血管性痴呆得分要高于阿尔茨海默病及混合性痴呆。APOEε4等位基因与阿尔茨海默病密切相关。结论阿尔茨海默病为主要的痴呆类型,其次为血管性痴呆、混合性痴呆、额颞叶痴呆及其他类型痴呆。阿尔茨海默病、血管性痴呆及混合性痴呆在认知功能损害方面存在差异。阿尔茨海默病与APOE4基因相关。Objective To investigate the visit rate of neurology outpatients with dementia over 55 years,the distribution and clinical feature of its subtypes, the association between APOE genotypes and Alzheimer＇s disease. Methods To detect APOE genotypes in the blood of dementia patients, diagnosed by cognitive function decline insiders questionnaire （ IQCODE ）, Mini Mental State scale （ MMSE ）, Hachinski Ischemic Index Scale （ HIS ）, activities of daily living scale （ ADL ）, Neuropsychiatric Questionnaire （ NPI）, Hamilton Depression Scale, spontaneous clock drawing test（CDT） and clinical Dementia Rating Scale（CDR） ,in 14 286 outpatients at the Sichuan Provincial People＇s Hospital Neurology Clinic from September 25 2009 to December 25 2009. Results Alzheimer＇s disease （AD） accounted for 1.99% in all neurology outpatients, followed in order by vascular dementia（VD） 0.95%, mixed dementia 0. 47%, frontotemporal dementia 0. 19%, other types of dementia 0. 19% ; in patients of dementias, AD accounted for 52. 5% ,VD 25% ,mixed dementia 12. 5% ,frontotemporal dementia 5% ,other types of dementia 5%. The scores of immediate memory, delayed memory,long-delayed recognition in AD and mixed dementia patients were lower than VD patients; No difference in AD, VD, mixed dementia patients＇scores of orientation, judgment and calculation, the activities of daily living; Hamilton depression scale scores in Mild AD, mixed dementiapatients were higher than the moderate to severe AD and VD patients;the mental test score of moderate and severe AD, VD patients, were higher than mixed dementia and mild AD; scores of Clock Drawing Task in VD patients were higher than AD patients. ApoEε4 allelic was closely related to AD. Conclusions AD is the main type of dementia, followed successively by VD, mixed dementia, frontotemporal dementia, other types of dementia. AD, VD and mixed dementia patients have differences in cognitive impairment. APOE gene is related to AD.

关 键 词：痴呆 流行病学 认知 APOE基因 

分 类 号：R749.1[医药卫生—神经病学与精神病学]