阿尔茨海默病患者视空间功能与平衡功能的相关研究  

Effects of visuospatial function on balance function in patients with Alzheimer＇s disease

作　　者：金梅[1] 潘园园[1] 谢文姣 欧阳晖[1] 徐乐平[1] 

机构地区：[1]解放军第一○二医院精神科,常州213003

出　　处：《中华精神科杂志》2016年第5期286-291,共6页Chinese Journal of Psychiatry

基　　金：全军医药卫生科研基金（MS020）

摘　　要：目的 探讨阿尔茨海默病（Alzheimer＇s disease,AD）患者视空间功能与平衡功能的相关关系.方法 采用Berg平衡量表（Berg Balance Scale,BBS）对116例轻或中度AD患者进行平衡功能测评;采用线方向判断测验及视觉形状辨别测验、视觉单目标持续操作试验、Corsi木块回忆任务,分别评定患者视空间感知、视空间注意、视空间工作记忆功能.采用偏相关分析分析视空间功能测验结果与BBS评分的关系.视空间功能对AD患者平衡功能的影响采用Logisitic回归分析.结果 BBS总分＜46分者29例（平衡障碍组）,BBS总分≥46分者87例（平衡正常组）;平衡障碍组线方向判断测验评分[（12.8±2.6）分与（14.8±3.0）分,t=3.218,P＜0.01]、Corsi木块回忆任务评分[（3.5±0.8）分与（4.1±1.3）分,t=2.433,P＜0.05]低于平衡正常组,视觉单目标持续操作试验漏答率高于平衡正常组[（10.3±2.4）％与（8.9±1.4）％,t=2.986,P＜0.01],差异有统计学意义.AD患者线方向判断测验分与BBS总分（r=0.256,P＜0.01）、动态平衡功能分（r=0.227,P＜0.01）正相关;视觉单目标持续操作试验漏答率与BBS总分（r=-0.310,P＜0.01）、静态平衡功能分（r=-0.204,P＜0.01）、动态平衡功能分（r=-0.305,P＜0.01）负相关.Logisitic回归分析显示,线方向判断测验分（OR=0.780,95％CI0.653～0.931,P＜0.01）、视觉单目标持续操作试验漏答率（OR=1.033,95％CI 1.004～1.062,P＜0.05）为AD患者平衡功能障碍的独立影响因素.结论 AD患者视空间功能较差者平衡功能也相对较差;视空间感知、视空间注意功能受损是AD患者平衡障碍的独立危险因素之一.Objective To evaluate the effects of visuospatial function on balance function in patients with Alzheimer＇s disease （AD）.Methods A clinical balance function survey was conducted with Berg Balance Scales （BBS） on a total of 116 patients with mild-moderate AD.Judgment of line orientation test and visual form discrimination test,visual one objective continuous performance test,and Corsi block recall were used to assess the ability of visuospatial perception,visuospatial attention,and visuospatial working memory respectively in AD patients.Partial correlation was used for analysis of relationships between the results of visuospatial function test and BBS,while the logisitic analysis was used for the exploring of visuospatial function effects on balance function in AD patients.Results Subjects were defined as AD patients with impaired balance function （29 cases） with the scores of BBS lower than 46,or AD patients with normal balance function （87 cases） with the scores of BBS higher than or equal to 46.Compared to AD patients with normal balance function,AD patients with impaired balance function showed significant lower scores of judgment of line orientation test （12.8 ±2.6 vs.14.8 ± 3.0,t=3.218,P＜0.01）,Corsi block recall （3.5±0.8 vs.4.1 ± 1.3,t=2.433,P＜0.05）,and higher omission error rate of visual one objective continuous performance （（10.3±2.4）％ vs.（8.9± 1.4）％,t=2.986,P＜0.O1）.Scores of judgment of line orientation test positively correlated with the scores of BBS （r=0.256,P＜0.01） and the scores of dynamic balance subscale of BBS （r=0.227,P＜0.01）.Scores of omission error rate of visual one objective continuous performance negatively correlated with the scores of BBS （r=-0.310,P＜0.01）,the scores of static balance subscale of BBS （r=-0.204,P＜0.01）,and the scores of dynamic balance subscale of BBS （r=-0.305,P＜0.01）.Logisitic analysis showed that the scores of judgment of line orientation test （OR=0.780,95％CI 0.653-0.931,P＜0.01）

关 键 词：阿尔茨海默病 认知 视空间功能 平衡 

分 类 号：R749.16[医药卫生—神经病学与精神病学]