不同神经系统症状或临床特征老年痴呆患者痴呆严重程度比较  

Comparison of severity of dementia in AD patients with different neurological symptoms or clinical features

作　　者：丘伟贤 吴盛各 周剑锋 颜小波 邓燕玲 陈志明 黎燕仪 李华兴 康渭岚 苏国兰 Qiu Weixian;Wu Shengge;Zhou Jianfeng;Yan Xiaobo;Deng Yanling;Chen Zhiming;Li Yanyi;Li Huaxing;Kang Weilan;Su Guolan(Department of Neurology,Guangdong Tongjiang Hospital,Foshan 528300,China)

机构地区：[1]广东同江医院神经内科

出　　处：《山西医药杂志》2020年第6期656-659,共4页Shanxi Medical Journal

基　　金：广东省佛山市科技攻关计划项目(2017AB003223)

摘　　要：目的 分析不同临床并发疾病或临床特征对老年痴呆(AD)患者痴呆严重程度的具体影响。方法 2017年8月至2019年8月,对广东同江医院67例AD患者和103名健康居民(认知正常组)进行调查研究。结合简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MOCA)对AD患者痴呆程度进行定量评定,分析并比较不同基本情况、神经系统症状、临床特征患者痴呆MMSE和MOCA量表评分的统计学差异。结果 2组对象MOCA量表评分比较,认知正常组MOCA量表总分高于AD组,认知正常组MOCA量表各维度评分均高于AD组,差异均有统计学意义(P<0.05)。AD伴发高血压的患者MOCA评分(18.6±1.6)低于无高血压患者(20.5±1.6),AD伴发高血压的患者MMSE评分(19.4±4.3)低于无高血压患者(23.9±3.5)。AD伴发缺血性脑卒患者MOCA评分(18.8±5.7)低于无高血压患者(22.5±5.3),AD伴发缺血性脑卒患者MMSE评分(20.4±4.3)低于无高血压患者(23.6±3.7),差异均有统计学意义(P<0.05)。AD伴发尿失禁表现患者MOCA评分(9.7±8.0)低于无尿失禁表现的患者(21.4±4.7),AD伴发尿失禁表现患者MMSE评分(14.4±7.7)低于无尿失禁表现的患者(23.0±3.4)。AD伴发走路姿势改变患者MOCA评分(18.3±6.4)低于无走路姿势改变的患者(21.8±4.7),AD伴发走路姿势改变患者MMSE评分(21.8±5.4)低于无走路姿势改变的患者(24.3±3.1)。结论 AD患者认知能力有明显下降,伴发高血压或缺血性脑卒中会进一步损害患者认知功能,认知水平较低的AD患者常常表现为尿失禁或走路姿势改变。Objective To analyze the effects of different clinical complications or clinical features on the severity of dementia in senile dementia patients.Methods From August 2017 to August 2019,the study was conducted on patients in Guangdong Tongjiang Hospital,including 67 patients with Alzheimer′s disease and 103 normal residents.The general demographic data,living habits,and disease history were collected.The MMSE and MOCA scales were used to quantitatively evaluate the degree of dementia in AD patients.The case-control study was used to explore the differences in behavioral characteristics and clinical manifestations between elderly dementia patients and normal subjects.Results The comparison of MOCA scale scores between the two groups showed that the total score of MOCA scale in the cognitively normal group was higher than that in the Alzheimer′s group.MOCA scale scores in all dimensions in the cognitively normal group were higher than those in the Alzheimer′s group,with statistically significant differences(P<0.05).MOCA score of AD patients with hypertension(18.6±1.6)was lower than that of those without hypertension(20.4±1.6),while MMSE score of AD patients with hypertension(19.4±4.3)was lower than that of AD patients without hypertension(23.9±3.5).MOCA score of patients with AD and ischemic stroke(18.8±5.7)was lower than that of patients without hypertension(22.5±5.3),and MMSE score of patients with AD and ischemic stroke(20.4±4.3)was lower than that of patients without hypertension(23.6±3.7),with statistically significant differences(P<0.05).The MOCA score of AD patients with urinary incontinence(9.7±8.0)was lower than that of AD patients without urinary incontinence(21.4±4.7),and MMSE score of AD patients with urinary incontinence(14.4±7.7)was lower than that of AD patients without urinary incontinence(23.0±3.4).MOCA scores of AD patients with walking posture change(18.3±6.4)were lower than those without walking posture change(21.8±4.7),and MMSE scores of AD patients with walking posture chan

关 键 词：神经系统 临床症状 阿尔茨海默病 

分 类 号：R749.16[医药卫生—神经病学与精神病学]