以痴呆、精神症状和运动迟缓为主要表现的路易体痴呆1例  

Lewy body dementia with dementia, psychiatric symptoms and bradykinesia as main manifestations：a case report

作　　者：尚延昌[1] 朱明伟[1] 陈彤[1] 张熙[1] 管维平[1] 解恒革[1] 贾建军[1] 王振福[1] 

机构地区：[1]解放军总医院南楼临床部神经内科,北京100853

出　　处：《中华老年多器官疾病杂志》2015年第8期632-636,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：路易体痴呆是引起老年人群痴呆的第二位常见病因，经尸检确诊的路易体痴呆国内少见报道。患者临床主要表现为进行性认知功能减退，伴有间歇性精神行为异常、视幻觉、对神经安定类药物敏感等症状，随病情进展会出现帕金森综合征和（或）自主神经系统功能障碍。现报道经尸检确诊的路易体痴呆1例，尸检病理结果表明大脑皮质及皮质下结构神经元胞浆内广泛存在α？共核蛋白染色阳性的路易小体，证实了生前临床诊断。希望通过学习本病例，提高国内各科医师对于路易体痴呆的认识水平，以利于本病的早期诊断。Dementia with Lewy bodies （DLB）, also known as Lewy body dementia, is the second most commonly degenerative cause of dementia in the elderly. At present, there are few reports about DLB confirmed by autopsy in our country. The main clinical manifestations of the patient were progressive cognitive decline, intermittent mental and behavior disorder, visual hallucination, sensitive to antipsychotic drugs, and parkinsonism and/or autonomic nervous system dysfunctions along with the progress. Here we reported such 1 case. The results of autopsy pathology showed thatα-synuclein positive Lewy bodies existed extensively in the cytoplasm of cortical and subcortical neurons, which verified the clinical diagnosis before the patient’s death. We hope to enhance the recognition of the disease and facilitate its early diagnosis through studying this case.

关 键 词：路易体痴呆 路易小体 Α-共核蛋白 尸检 

分 类 号：R592[医药卫生—老年医学] R749.1[医药卫生—内科学]